Preoperative evaluation of cardiac risk by means of atrial pacing and thallium 201 scintigraphy

Journal Article · Sun Oct 01 04:00:00 EDT 1989 · Journal of Vascular Surgery; (USA)

DOI:https://doi.org/10.1067/mva.1989.13734· OSTI ID:5226887

Stratmann, H G; Mark, A L; Walter, K E; Williams, G A ^[1]

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1. St. Louis Veterans Administration Medical Center, MO (USA)

Atrial pacing and thallium 201 scintigraphy were done in 61 patients with known or suspected coronary artery disease referred for evaluation of cardiac risk before elective vascular surgery. All patients had noncardiac limitations precluding performance of an adequate exercise stress test. Before atrial pacing all were considered to be at low risk of a postoperative cardiac event based on assessment of clinical parameters. Vascular surgery was subsequently performed in 47 patients. In these patients, pacing-induced ST segment depression greater than or equal to 1 mm occurred in 18, a fixed perfusion defect occurred in 11, and a reversible defect occurred in six. Two of the six patients with reversible perfusion defects had preoperative coronary angiography; both had significant coronary artery disease (one or more lesions greater than or equal to 50%). Two patients (one of whom had a reversible perfusion defect) underwent preoperative coronary revascularization and tolerated subsequent vascular surgery well. All other patients received only medical therapy. None of the 47 patients undergoing vascular surgery had a postoperative cardiac event (unstable angina, congestive heart failure, myocardial infarction, or cardiac death). Of the 14 patients in whom vascular surgery was deferred or canceled, surgery was canceled for noncardiac reasons in seven. Six of these seven patients had a normal perfusion scan; none had a reversible perfusion defect or marked (greater than or equal to 2 mm) ST segment depression. No cardiac event occurred during a 3-month period after atrial pacing in any of these patients. Six of the remaining seven patients had reversible perfusion defects.

• OSTI ID: 5226887
• Journal Information: Journal of Vascular Surgery; (USA), Journal Name: Journal of Vascular Surgery; (USA) Vol. 10:4; ISSN 0741-5214; ISSN JVSUE
• Country of Publication: United States
• Language: English

Related Subjects

550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
62 RADIOLOGY AND NUCLEAR MEDICINE
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BODY
CARDIAC PACEMAKERS
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
COUNTING TECHNIQUES
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DISEASES
EXERCISE
HEART
HEAVY NUCLEI
ISOTOPES
MEDICINE
MINUTES LIVING RADIOISOTOPES
NUCLEI
ODD-ODD NUCLEI
ORGANS
PATIENTS
RADIOISOTOPE SCANNING
RADIOISOTOPES
RISK ASSESSMENT
SCINTISCANNING
SURGERY
THALLIUM 210
THALLIUM ISOTOPES