title: Changes in septal regional ejection fraction early and late following coronary artery bypass grafting in patients without postoperative myocardial infarction.
abstract: Changes in regional ejection fraction (rEF) of the interventricular septum following coronary artery bypass graft (CABG) surgery were examined using first-pass radionuclide ventriculography (RNVG) in patients without objective evidence of postoperative myocardial infarction (MI). One hundred and one patients had pre- (mean 6.3 days) and early postoperative (mean 8.7 days) RNVGs, and 60 of these patients had follow-up studies at 14-39 months (mean 27 months) postsurgery. Early post-CABG, mean rEF in the proximal septum was unchanged from the preoperative value (35.3%), with almost equal numbers of patients showing increased (n = 36), unchanged (n = 33) or decreased (n = 32) rEFs. In the distal septum, mean rEF increased from 47.1 to 50.7%, with more than twice as many patients having increased (n = 44) as decreased (n = 20) rEF. At late follow-up, proximal septum rEF in individual patients tended to revert to the presurgery baseline, with 72% (13/18) of regions with early decrease improved and 61% (14/23) of those with early improvement decreased. In the distal septum, rEF was less than early post-CABG in 76% (19/25) of patients with early improvement, while being improved in 27% (3/11) of those with early decrease in rEF. In the absence of MI, changes in rEF in the proximal septum early post-CABG tend to resolve over time. While global changes in cardiac systolic motion are the probable cause of many new post-CABG septal abnormalities, persistent septal dysfunction probably reflects effects of permanent damage as a result of the operative procedure.
authors: Nuclear Medicine Service, Department of Veterans Affairs Medical Center, West Roxbury, MA 02132.
authors: A F
authors: AF
authors: Jacobson
authors: D E
authors: DE
authors: Tow
authors: D
authors: D
authors: Lapsley
authors: S
authors: S
authors: Khuri
mesh_terms: D000328:Adult; D000368:Aged; D001026:Coronary Artery Bypass; D005260:Female; D006346:Heart Septum / Q000000981:diagnostic imaging / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction; D011183:Postoperative Complications; D013318:Stroke Volume / Q000502:physiology*; D013997:Time Factors; D015646:Ventriculography, First-Pass