[Prediction and evaluation of surgical treatment results of severe ischemic heart disease]
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Updated: Aug 24, 2026
Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
Published on: March 27, 2018
Antanas Macys1, Ilona Kulakiene, Sarūnas Kinduris
1Institute for Biomedical Research, Kaunas University of Medicine, Lithuania. tonis@one.lt
Insights
Single-photon emission computed tomography (SPECT) effectively assesses myocardial perfusion recovery after coronary artery bypass grafting (CABG). Preoperative SPECT aids in predicting successful surgical revascularization outcomes.
Area of Science:
- Cardiology
- Nuclear Medicine
- Cardiovascular Surgery
Background:
- Severe coronary artery disease (CAD) often necessitates surgical intervention.
- Assessing myocardial perfusion is crucial for evaluating treatment efficacy in CAD patients.
- Coronary artery bypass grafting (CABG) aims to restore adequate blood flow to the heart muscle.
Purpose of the Study:
- To estimate myocardial perfusion before and after CABG using single-photon emission computed tomography (SPECT).
- To predict the success of complete myocardial revascularization based on preoperative perfusion data.
- To evaluate early postoperative recovery of myocardial perfusion.
Main Methods:
- Ten patients with severe CAD and left ventricular dysfunction underwent SPECT imaging.
- SPECT was performed at rest and after nitrate administration pre-CABG.
- Postoperative SPECT (3 and 6 months) assessed myocardial perfusion and recovery.
Main Results:
- Myocardial perfusion significantly improved in revascularized segments by 6 months post-CABG.
- The number of fixed perfusion defects showed a trend towards reduction by 6 months.
- Postoperative myocardial perfusion recovery exceeded preoperative predictions, indicating successful revascularization.
Conclusions:
- SPECT evaluation in the early postoperative period, especially at 6 months, confirms successful CABG outcomes.
- Preoperative SPECT with nitrate administration is valuable for predicting CABG results.
- Assessing fixed perfusion defects aids in predicting outcomes and identifying hibernating myocardium.
Objectives:
To estimate myocardial perfusion in patients with severe coronary artery disease performing before and early after single-photon emission computed tomography coronary artery bypass grafting; to predict results of complete myocardial revascularisation by preoperative perfusion data.
Material And Methods:
Ten patients with stable coronary artery disease and resting left ventricular wall motion abnormalities (mean ejection fraction 31.8+/-6.4%, mean wall motion index 2.09+/-0.25) underwent (99m)Tc-MIBI single-photon emission computed tomography at rest and after nitrate administration before coronary artery bypass grafting and stress-rest single-photon emission computed tomography early (3 and 6 months) after surgery. We estimated myocardial perfusion, postoperative recovery and calculated scintigraphic indices.
Results:
The mean number of distal anastomoses was 3.0+/-0.7 and all of the patients had complete myocardial revascularisation. Out of 84 revascularized segments with different degree of myocardial perfusion disorders, 49 (58.3%) segments improved after 3 months and 53 (63.1%) improved after 6 months postoperatively. Amount of segments with fixed perfusion defects increased from 60 preoperatively to 72 after 3 months and 67 after 6 months. Postoperative myocardial perfusion recovery was incomplete following 3 months, but after 6 months it nearly reached ultimate level. Postoperative index of myocardial perfusion recovery was found better than predicted preoperatively.
Conclusions:
Estimation of myocardial perfusion changes with single-photon emission computed tomography during early postoperative period, particularly after 6 months, confirms excellent and final results of complete surgical myocardial revascularization. Preoperative single-photon emission computed tomography after nitrate administration provides more information in prediction of postoperative results of complete myocardial revascularization. Estimation of function of fixed perfusion defects can help to predict correct results and to identify hibernating myocardium.
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