Dipyridamole thallium scanning in the evaluation of coronary artery disease in elective abdominal aortic surgery
- Department of Surgery, Veterans Affairs Medical Center, Martinez, CA (USA)
Dipyridamole thallium scanning was routinely performed on 68 consecutive patients who presented for elective aortic surgery. All 68 patients were judged by clinical assessment to be at low risk for perioperative cardiac complications. In addition, 42 of 68 patients had a history of myocardial infarction, stable angina, or abnormal echocardiographic findings (group 1). Twenty-six of 68 patients did not have a history of myocardial infarction, angina, or abnormal echocardiographic findings (group 2). In group 1, 34 of 4 patients had positive results on dipyridamole thallium scanning, and 15 of these patients were found to have critical coronary artery disease on subsequent cardiac catheterization; nine underwent immediate coronary artery bypass grafting, and six had their coronary artery disease treated medically and their vascular operations cancelled. The remaining 27 patients in group 1 underwent elective operations, with six (22%) of 27 sustaining postoperative cardiac complications. None of the group 2 patients was found to have critical coronary artery disease. All patients in group 2 underwent aortic operation without cardiac complication. Routine dipyridamole thallium scanning detected a 22% (15 of 68) incidence of critical coronary artery disease overall. There was a 36% (15 of 42) incidence of critical coronary artery disease in group 1 patients vs 0% in group 2 patients (95% confidence interval, 21% to 50%). The authors conclude that the use of dipyridamole thallium scanning in low-risk patients for cardiac screening prior to elective aortic operations is beneficial in selected patients who have a history of myocardial infarction, angina, or abnormal echocardiographic findings, but is not necessary in patients with no history of coronary artery disease.
- OSTI ID:
- 5321237
- Journal Information:
- Archives of Surgery (Chicago); (United States), Vol. 126:7; ISSN 0004-0010
- Country of Publication:
- United States
- Language:
- English
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Related Subjects
CARDIOVASCULAR DISEASES
DIAGNOSIS
AORTA
PATIENTS
RADIOISOTOPE SCANNING
SURGERY
THALLIUM ISOTOPES
VASODILATORS
ARTERIES
BLOOD VESSELS
BODY
CARDIOVASCULAR AGENTS
CARDIOVASCULAR SYSTEM
COUNTING TECHNIQUES
DISEASES
DRUGS
ISOTOPES
MEDICINE
ORGANS
550601* - Medicine- Unsealed Radionuclides in Diagnostics