Document Detail


Can preoperative myocardial perfusion scintigraphy predict changes in left ventricular perfusion and function after coronary artery bypass graft surgery?
MedLine Citation:
PMID:  22473665     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES We wanted to evaluate whether preoperative myocardial perfusion scintigraphy (MPS) could predict changes in cardiac symptoms and postoperative myocardial perfusion and left ventricular function after coronary artery bypass grafting (CABG). METHODS Ninety-two patients with stable angina pectoris (and at least one occluded coronary artery) underwent MPS before, and 6 months after, undergoing CABG. The result of the MPS was kept secret from the surgeons. RESULTS Before CABG, 90% of the patients had angina. After CABG, 97% of the patients were without symptoms. Overall graft patency was 84%. Before CABG, one patient had normal perfusion; in the rest of them the defects were classified as follows: reversible (60%), partly reversible (27%) and irreversible (12%). Following CABG, 33% had normal perfusion; in the rest the defects were reversible in 29%, partly reversible in 12% and irreversible in 26%. Left ventricular ejection fraction (LVEF), which was normal before operation in 45%, improved in 40% of all patients. The increase in LVEF was not related to the preoperative pattern of perfusion defects. Of 30 patients with normalized perfusion after CABG, 29 (97%) had reversible defects and one patient had partly reversible defects. Of 83 perfusion defects, which were normalized after CABG, 67 were reversible (81%) or partly reversible (12%). Seventy-five percent of all reversible coronary artery territories before CABG were normalized after operation. CONCLUSIONS Our results indicate that reversible or partly reversible perfusion defects at a preoperative MPS have a high chance of normalized myocardial perfusion assessed by MPS 6 months after operation. Normal perfusion is obtained almost exclusively in territories with reversible ischaemia. Symptoms improved in nearly all patients and LVEF in a significant fraction of the patients, not related to preoperative MPS.
Authors:
Rozy Eckardt; Bo Juel Kjeldsen; Allan Johansen; Peter Grupe; Torben Haghfelt; Per Thayssen; Lars Ib Andersen; Birger Hesse
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-04-02
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  14     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-05-16     Completed Date:  2012-09-07     Revised Date:  2013-06-05    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  779-84     Citation Subset:  IM    
Affiliation:
Department of Cardiothoracic Surgery, Institute of Clinical Research, Odense University Hospital, Odense, Denmark. rozy@eckardtmail.dk
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MeSH Terms
Descriptor/Qualifier:
Aged
Angina Pectoris / physiopathology,  radionuclide imaging,  surgery
Coronary Angiography
Coronary Artery Bypass* / adverse effects
Coronary Artery Disease / physiopathology,  radionuclide imaging*,  surgery*
Coronary Circulation*
Denmark
Female
Humans
Male
Middle Aged
Myocardial Perfusion Imaging / methods*
Predictive Value of Tests
Preoperative Care
Prospective Studies
Radiopharmaceuticals / diagnostic use
Recovery of Function
Stroke Volume*
Technetium Tc 99m Sestamibi / diagnostic use
Time Factors
Treatment Outcome
Vascular Patency*
Ventricular Function, Left*
Chemical
Reg. No./Substance:
0/Radiopharmaceuticals; 109581-73-9/Technetium Tc 99m Sestamibi
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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