Accuracy of serial myocardial perfusion scintigraphy with /sup 201/Tl for prediction of graft patency early and late after coronary artery bypass surgery. A controlled prospective study

Journal Article · Mon Nov 01 04:00:00 EST 1982 · Circulation; (United States)

DOI:https://doi.org/10.1161/01.CIR.66.5.1017· OSTI ID:6492813

Pfisterer, M; Emmenegger, H; Schmitt, H E; Mueller-Brand, J; Hasse, J; Graedel, E; Laver, M B; Burckhardt, D; Burkart, F

To assess the accuracy of serial myocardial perfusion scintigraphy with /sup 201/Tl to predict graft patency early and late coronary artery bypass surgery, rest and exercise /sup 201/Tl and coronary arteriography were performed preoperatively and 2 weeks and 1 year after operation. The scintigraphic results were compared with graft patency, symptoms, left ventricular function and physical work capacity in a consecutive series of 55 patients with a total of 154 grafts. Serial /sup 201/Tl had an 80% sensitivity, 88% specificity and 86% overall accuracy in detecting or excluding graft occlusion, which was predicted by reversible ischemia as well as persistent new scar segments. Occluded grafts were correctly localized by /sup 201/Tl scintigraphy in 61%. Postoperative apical /sup 201/Tl defects were frequent (two-thirds of cases), and were the result of intraoperative transapical venting of the left ventricle. After coronary bypass graft surgery, ejection fraction at rest was unchanged. Left ventricular end-diastolic pressure and physical work capacity improved significantly. In the presence of new perfusion defects detected postoperatively, physical work capacity was reduced significantly. New /sup 201/Tl defects in addition to typical or atypical angina provided a high probability of graft occlusion, while in the absence of new /sup 201/Tl defects all grafts were patent in more than 90% of patients, all of whom had no or only atypical chest pain. We conclude that serial /sup 201/Tl imaging after coronary artery bypass surgery is an accurate noninvasive method that can be used routinely to assess graft function, to localize spatially occluded grafts and to identify patients with a high likelihood of graft occlusion who may need invasive studies.

• Research Organization: Department of Internal Medicine, University Hospital, Basel, Switzerland
• OSTI ID: 6492813
• Journal Information: Circulation; (United States), Journal Name: Circulation; (United States) Vol. 66:5; ISSN CIRCA
• Country of Publication: United States
• Language: English

Related Subjects

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59 BASIC BIOLOGICAL SCIENCES
62 RADIOLOGY AND NUCLEAR MEDICINE
ARTERIES
BETA DECAY RADIOISOTOPES
BLOOD VESSELS
BODY
CARDIOVASCULAR SYSTEM
CORONARIES
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DIAGNOSTIC USES
ELECTRON CAPTURE RADIOISOTOPES
GRAFT-HOST REACTION
GRAFTS
HEART
HEAVY NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MEDICINE
MUSCLES
MYOCARDIUM
NUCLEI
ODD-EVEN NUCLEI
ORGANS
PATIENTS
RADIOISOTOPE SCANNING
RADIOISOTOPES
SCINTISCANNING
SECONDS LIVING RADIOISOTOPES
SURGERY
THALLIUM 201
THALLIUM ISOTOPES
TRANSPLANTS
USES