EDITORIAL

Collaterals: how important are they?

Gerald S Werner

Correspondence to:
Correspondence to:
Professor G S Werner
Medizinische Klinik I, Klinikum Darmstadt, Grafenstrasse 9, D-64283 Darmstadt, Germany; gerald.werner@klinikum-darmstadt.de

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See article on page 842

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The first 150 words of the full text of this article appear below.

The question of "how important collaterals are" is a rhetorical one. The essential value of collaterals is clearly demonstrated in patients with a completely preserved left ventricular function despite a totally occluded coronary artery. There is even the anecdotal argument that collaterals might be so well developed that the revascularisation of an occluded coronary artery might not be required, but clinical data suggest that revascularising a chronic coronary occlusion provides a survival benefit.^1,2 Furthermore, the quantitative assessment of collateral function demonstrated that <5% of occluded arteries in patients without a prior myocardial infarction receive collateral supply equivalent to an open epicardial artery.³

Recovery of functionally impaired myocardium after revascularisation can only be expected with a minimum collateral supply to maintain myocardial viability.⁴ In the absence of collaterals, no viable myocardium will be found,^5,6 but there is a dispute about whether the extent of collaterals is directly related to viability and . . . [Full text of this article]

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