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Updated: Jul 3, 2026
In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
Nuclear cardiology and coronary surgery
R Eckardt1, L I Andersen, B Hesse
1Department of Cardiothoracic Surgery, Odense University Hospital, Odense, Denmark.
Insights
Coronary artery bypass grafting (CABG) patients are increasingly complex. Preoperative myocardial perfusion imaging improves surgical success and reduces complications in these high-risk individuals.
Area of Science:
- Cardiology
- Cardiac Surgery
- Nuclear Cardiology
Background:
- Coronary artery bypass grafting (CABG) patient profiles have shifted towards older individuals with multiple comorbidities like obesity, diabetes, and hypertension.
- This complex patient demographic contributes significantly to the growing population with heart failure, where treatment outcomes remain suboptimal.
- Coronary artery bypass grafting offers potential benefits but requires careful risk-benefit assessment, especially concerning operative complications.
Purpose of the Study:
- To evaluate the role of preoperative myocardial perfusion imaging in optimizing decision-making for coronary artery bypass grafting.
- To enhance the accuracy of identifying culprit lesions and assessing the severity of coronary stenoses.
- To improve the success rates and reduce operative risks associated with coronary artery bypass grafting in high-risk patients.
Main Methods:
- Utilizing single photon emission computed tomography (SPECT) or positron emission tomography (PET) for myocardial perfusion imaging.
- Correlating perfusion abnormalities with angiographic findings of coronary stenoses.
- Assessing myocardial viability and coronary hemodynamics prior to surgical intervention.
Main Results:
- Preoperative myocardial perfusion imaging provides critical information on coronary hemodynamics and myocardial viability.
- This imaging modality aids in accurately identifying the extent and location of perfusion defects relative to coronary stenoses.
- Improved preoperative information supports better surgical planning and patient selection for coronary artery bypass grafting.
Conclusions:
- Myocardial perfusion imaging is highly recommended before coronary artery bypass grafting in complex patients.
- It increases the likelihood of successful coronary surgery by providing detailed hemodynamic and viability data.
- This approach helps mitigate the risk of operative complications and improves overall patient outcomes.
Abstract:
Rising age, repeated percutaneous coronary revascularizations, and co-morbidity such as overweight, diabetes, and hypertension, characterize a change over the last 20-30 years in coronary patients referred to coronary artery bypass grafting (CABG). This patient group represents a great part of today's large and increasing patient population with heart failure, and their treatment remains a limited success. CABG may lead to symptomatic and prognostic improvement, but the limited risk of operative complications has to be balanced against the chances of symptomatic and prognostic benefit from the operation. Identification of culprit lesions and estimation of the severity of coronary stenoses of intermediate or uncertain degree are important in preoperative decision-making. Location and extent of a perfusion abnormality must reflect the anatomical distribution of an angiographic stenosis, supporting or arguing against the decision to revascularize . Myocardial perfusion imaging by single photon emission computed tomography or positron emission tomography before surgery will increase the level of information about coronary hemodynamics and myocardial viability before surgical intervention and is therefore highly recommended to increase the chances of successful coronary surgery, as well as to reduce the small risk of operative complications.
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