title: The role of myocardial viability assessed by perfusion/F-18 FDG imaging in children with anomalous origin of the left coronary artery from the pulmonary artery.
abstract: OBJECTIVE
  Although surgical treatments evolved, the short-term postoperative mortality is still high in children with anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA), and long-term survivors may suffer from restrained functional recovery. Therefore, an optimal means in predicting postoperative reversal is demanded. In this study, we assess the utility of myocardial perfusion/F-18 fluorodeoxyglucose (FDG) imaging in the evaluation of myocardial viability and postsurgery functional recovery in children with ALCAPA.
  
  
  METHODS
  A retrospective study was performed in 7 children with diagnosed ALCAPA who underwent myocardial perfusion/F-18 FDG imaging preoperatively. Global viability index was used to evaluate myocardial viability and was compared with the preoperative deviations of left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVEDD) from age-matched healthy children and with the postoperative durations of intensive care.
  
  
  RESULTS
  Children with more viable myocardium had less severe clinical symptoms. The viability index was correlated well with the preoperative deviations of LVEF (r = -0.98, P = 0.001) and LVEDD (r = 0.87, P = 0.02) and postoperative durations of intensive care hospitalization (r = 0.77, P = 0.04) and mechanical ventilation (r = 0.83, P = 0.02). LVEF and LVEDD reached normal range within 5 months in viable children, whereas incomplete reversal was observed in partial- and nonviable children.
  
  
  CONCLUSIONS
  In children with ALCAPA, myocardial viability evaluated by perfusion/F-18 FDG imaging is related to the preoperative clinical manifestations and cardiac function. Additionally, it may predict functional recovery after surgical repair.
authors.affiliation: Department of Nuclear Medicine, Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Min-Fu
authors.initials: MF
authors.lastname: Yang
authors.forename: Bo-Qia
authors.initials: BQ
authors.lastname: Xie
authors.forename: Xiao-Dong
authors.initials: XD
authors.lastname: Lv
authors.forename: Zhong-Dong
authors.initials: ZD
authors.lastname: Hua
authors.forename: Fu-Jian
authors.initials: FJ
authors.lastname: Duan
authors.forename: Chao-Wu
authors.initials: CW
authors.lastname: Yan
authors.forename: Guang
authors.initials: G
authors.lastname: Xu
authors.forename: Li-Ping
authors.initials: LP
authors.lastname: Song
authors.forename: Yue-Qin
authors.initials: YQ
authors.lastname: Tian
authors.forename: Shou-Jun
authors.initials: SJ
authors.lastname: Li
mesh_terms: D001159:Arterio-Arterial Fistula / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D003330:Coronary Vessel Anomalies / Q000000981:diagnostic imaging*; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007223:Infant; D008297:Male; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D017682:Myocardial Stunning / Q000000981:diagnostic imaging*; D011651:Pulmonary Artery / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D011859:Radiography; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18