Myocardial infarction during coronary artery bypass surgery

Ressonância magnética vs cintilografia com pirofosfato marcado com tecnécio-99m para a detecção de necrose miocárdica perioperatória

“…An option would be the use of planar scintigraphy, which can be performed at bedside. However, its sensitivity is known to be lower than that of tomographic acquisition (SPECT) for the detection of nontransmural infarcts 7 , which are the most common in the perioperative setting. Also, the prolonged pyrophosphate persistence in the blood pool verified in some cases may have influenced the accuracy of the tests, thus partially limiting the diagnostic quality of the images.…”

“…Among the tests used for its diagnosis, technetium-99m pyrophosphate myocardial scintigraphy (MS) stands out as a noninvasive method able to visualize areas of myocardial necrosis 6 . Despite its good sensitivity in detecting transmural infarction, planar scintigraphy has a low sensitivity in detecting subendocardial infarction, which is the most common type following CABG 7 . The single-photon emission computed tomography technique, better known as SPECT, has a higher sensitivity in detecting subendocardial infarction; however its specificity is also limited 6 .…”

“…The single-photon emission computed tomography technique, better known as SPECT, has a higher sensitivity in detecting subendocardial infarction; however its specificity is also limited 6 . Additionally, the test remains positive for a relatively short time, approximately seven days [7][8][9] , based on the radionuclide binding to mitochondrial calcium of myocytes affected by the infarction, and this may limit its use within the first postoperative days in clinically unstable patients who cannot be transferred to the Nuclear Medicine department.…”

Treatment of Coronary Artery Bypass Graft Failure

“…[134][135][136] The most common graft-related causes of myocardial ischemia after CABG are graft occlusion due to acute graft thrombosis, graft kinking or overstretching, postoperative graft spasm and subtotal or hemodynamic relevant anastomotic stenosis. [137,138] Nongraft-related causes for myocardial ischemia after CABG are surgery-related possibly due to surgical manipulation on pre-existing microembolizing and disintegrating unstable plaque and include inadequate cardioplegic perfusion and myocardial protection, incomplete revascularization, or distal coronary microembolization. [139][140][141] Rapid identification of early graft failure after CABG and diagnostic discrimination from other causes enables an adequate reintervention strategy for re-revascularization, i.e.…”

Clinical significance, angiographic characteristics, and short-term outcomes in 30 patients with early coronary artery graft failure

“…[1][2][3] Furthermore, postoperative myocardial ischaemia has been linked to a decreased late survival. 2 Coronary angiography has proven to be safe and precise to confirm early graft failure.…”