Exercise technetium 99m sestamibi single‐photon emission computed tomography late after coronary artery bypass surgery: Long‐term follow‐up

Abstract

Backgroundand hypothesis: The prognostic value of exercise technetium 99m sestamibi single-photon emission computed tomography (SPECT) imaging in patients with previous bypass surgery is unknown. The aim of our study was to assess the prognostic information obtained with exercise scintigraphy performed for routine follow-up or reappearance of symptoms.Methods: We studied 75 patients referred to our Center at a mean of 38 2 53 months from the revascularization procedure and prospectively followed them for 38 -c 24 months.Results: Fifteen patients (20%) had events at follow-up:there were 4 cardiac deaths, 3 nonfatal acute myocardial in- Conclusions: Exercise sestamibi SPECT scintigraphy provides optimal prognostic information after clinical and ergometric parameters in patients with previous bypass surgery.

Myocardial perfusion scintigraphy: the evidence

“…In patients with ischaemic left ventricular dysfunction, MPS can define the need for revascularisation by determining the presence and extent of ischaemia and of viable but hibernating myocardium [ 193 , 194 , 195 , 196 ] (Table 9 ). This is particularly the case with severe left ventricular dysfunction, when MPS can predict the improvement in left ventricular function and the overall prognosis [ 181 , 197 , 198 ]. MPS is most helpful when left ventricular ejection fraction is severely reduced, and in these high-risk patients rest imaging alone can detect viable myocardium [ 199 , 200 , 201 , 202 , 203 , 204 ].…”

“…Chest pain and exercise electrocardiography are largely unhelpful in identifying patients at risk after revascularisation [ 209 ] but MPS is of proven value [ 197 , 208 , 210 , 211 , 212 ]. In the NIH-sponsored Emory Angioplasty versus Surgery Trial (EAST), inducible perfusion abnormalities 1 year after revascularisation separated the patients into low- and high-risk groups [ 213 ].…”

Nichtinvasive Angiographie koronarer Bypassgefäße mit dem Cardio-CT in einer kardiologischen Praxis

“…Zunächst muss betont werden, dass Patienten mit (wieder aufgetretener) typischer Angina pectoris und/oder eindeutigem Ischämienachweis mittels Belastungs-EKG, Stressechokardiographie oder Myokardszintigraphie [17,36,49] primär einer Linksherzkatheteruntersuchung zugeführt werden sollten, da auch bei offenen Bypassgefäßen Stenosen der distalen Anastomosen und/oder eine Progression der Nativgefäße vorliegen könnten.…”