[Diagnostic approach in coronary disease in vascular surgery. Role of myocardial scintigraphy].
Dipyridamole thallium scintigraphy (tomo SMTD) (fig. 2) and a bicycle stress-testing ECG were performed in a prospective study of 102 patients (Tabl. VIII) referred for aortic reconstruction surgery with aortic cross-clamping (fig. 1), carried out without knowledge of tomo SMTD results. A clinical coronary artery disease (CAD) was suspected in 45 patients (44%). The exercise test (tabl. IV) was inadequate in 78%, normal in 11% and abnormal in 11% of patients. Tomo SMTD (tabl. VI et X) was normal in 60 patients (59%), abnormal with persistent defect in 21 (20.5%) and abnormal with transient defect in 21 (20.5%). Post-operative cardiac events (tabl. I) occurred in 4 patients (3.9%): 2 deaths, 1 non-fatal myocardial infarction and 1 rest angina; but only 2 of these had documented CAD. All 4 had abnormal tomo SMTD (3 with transient, 1 with persistent defect). It is concludes that abnormal tomo SMTD had a significant pronostic value (p less than 0.03) in predicting post-perative cardiac events (tabl. XI, fig. 3) after abdominal aortic surgery with cross-clamping. This test facilitates selection of patients for coronary angiography.
Gillet
T
T
Service de Cardiologie, CHU Timone, Marseille.
Lecorff
G
G
Scemama
J
J
Bernard
P J
PJ
Mercier
C
C
Serradimigni
A
A
D000368:Aged; D001012:Aorta, Abdominal; D001018:Aortic Diseases / Q000601:surgery*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D004176:Dipyridamole; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011300:Preoperative Care; D011446:Prospective Studies; D011877:Radionuclide Imaging; D012307:Risk Factors
D004176:Dipyridamole
Approche diagnostique de la coronaropathie en chirurgie vasculaire. Place de la scintigraphie myocardique.