title: Early postoperative assessment of coronary artery bypass surgery using nuclear left ventriculography and atrial pacing.
abstract: Nuclear ventriculography (MUGA) was performed in 22 patients at rest and during the stress of right atrial pacing 6 to 8 days after coronary artery bypass surgery. In 7 patients the MUGA-atrial pacing test was positive for ischemia with chest pain, electrocardiographic ST depression and/or a decrease in global left ventricular ejection fraction of greater than 10%. All 7 patients subsequently developed angina pectoris with a positive treadmill test (performed at a median time of 14 months after operation). In 15 patients, the early postoperative MUGA-atrial pacing test was negative. In this group, 3 patients subsequently developed angina pectoris with a positive treadmill test in one. The sensitivity of the 'one week' early postoperative MUGA-atrial pacing in the identification of patients with residual myocardial ischemia was high (88% for positive GXT, p less than 0.0001; 70% for chest pain, p less than 0.005) with 100% specificity. The early postoperative MUGA scan was also useful in predicting later shortness of breath on exertion and there was a significant correlation between the early resting ejection fraction and the exercise capacity of the patient subsequently. The information obtained from an early postoperative MUGA-atrial pacing study may have far-reaching and important practical application in selecting patients for early recatheterization, possible fibrinolysis and/or possible cardiac reoperation.
mesh_terms: D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000175:diagnosis; D002304:Cardiac Pacing, Artificial; D001026:Coronary Artery Bypass; D004562:Electrocardiography; D004912:Erythrocytes; D005080:Exercise Test; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006333:Heart Failure / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis; D011184:Postoperative Period; D011877:Radionuclide Imaging; D012008:Recurrence; D013318:Stroke Volume; D013667:Technetium; D013997:Time Factors
chemical_list: D013667:Technetium