983-33 Safety Evaluation of a New Infusion-Perfusion Catheter: Vectocardiographic, Left Ventricular and Coronary Hemodynamic During Local Drug Delivery

Abstract

Aim of the study was to assess adequacy of myocardial perfusion during deployment of a new intracoronary drug delivery device (D-3. Dispatch tm Scimed). In 22 patients (13 men, 57 ± 10 years) following conventional angioplasty D-3 was inflated at the site of angioplasty. During inflation blood velocity was measured distal to the device at baseline and after drug induced hyperaemia. An angiography was performed to quantify the coronary crosssectional area at the site of Doppler sampling volume to calculate blood-flow. Hemodynamic (high fidelity tip manometer-pigtail in the left ventriclel and vectorcardiography was monitored continuously. During D-3 inflation (mean inflation time 29 ± 8 min) 5 patients had mild chest pain. No significant vectorcardiographic changes were observed during prolonged inflation, Isovolumetric indices of contraction (+dP/dt, V max) and relaxation (–dP/dt, Tau1) at baseline before PTCA and D-3, at the end of PTCA and D-3 inflation, respectively, were as follows: Baseline–PTCA Baseline–D-3 +dP/dt (mmHg/sec) 1313 ± 195 NS 1277 ± 281 1247 ± 218 NS 1332 ± 342 Vmax (sec -1 ) 52 ± 8 NS 54 ± 10 50 ± 8 NS 51 ± 9 –dP/dt (mmHg/sec) 1634 ± 309 *** 1350 ± 374 1522 ± 256 NS 1548 ± 309 Tau1 (msee) 55 ± 10 *** 70 ± 12 60 ± 9 NS 62 ± 8 Mean ± SD. NS = non significant *** p < 0.001 (paired t-test) During intracoronary D-3 inflation basal and hyperaemic flow were 44 ± 31 ml/min and 78 ± 59 ml/min. In conclusion this new infusion catheter allows a nearly normal basal coronary flow with even preserved hyperaemic response during inflation and is subjectively and hemodynamically well tolerated during prolonged inflation permitting sustained local intracoronary drug delivery.