Abstract 12820: Utilization of Cardiac Magnetic Resonance Imaging for Management of Coronary Chronic Total Occlusions

• DOI: 10.1161/circ.146.suppl_1.12820
• Publication Date: 2023-06-15T15:53:36Z
• Authors: Caitlin S Drescher; Anna Lisa Chamis; Harsh Patolia; John Tanaka; Manasi Tannu; Islam Othman; William S Jones; Jennifer A Rymer
• Keywords: Mace; Cardiac magnetic resonance; Angiology

Introduction: Revascularization of coronary chronic total occlusions (CTOs) may be indicated for relief medically refractory angina. Myocardial viability assessment by cardiac magnetic resonance (CMR) help select patients CTO intervention. Real-world practice is not well described. Methods: We identified who underwent angiography between 2016-2020 at a large tertiary center and had ≥1 CTO. Patients with prior CABG were excluded. examined rates CMR outcomes including revascularization MACE. segments attributed to territory adjudicated following angiographic review anatomy. Significant was defined as <50% transmural delayed enhancement in the territory. Results: 1279 (74.1% male, 28.1% Black) met inclusion criteria. Of these, 36.0% type 2 diabetes mellitus 54.9% reported angina pectoris. Over half RCA (56.5%), 18.5% >1 vessel. Non-invasive testing performed 38.4% patients; 10.8% CMR. Rates higher severely reduced EF (≤35%) compared those normal (≥55%) (22.1% vs 11.1%; p<0.001). Among CMR, 84.8% showed significant (Fig). PCI 12.5% patients, 24.9%, 63.2% managed medically. versus without (70.0% 52.8%; p<0.001) more likely on ≥2 anti-anginal medications (30.6% 18.9%; technical success achieved 69.5% MACE occurred 2.3% cases. Conclusions: CTOs demonstrate high territories based remain low. Further work needed determine role other non-invasive management.