Value of PET scan for semi quantitative assessment of myocardial viability before CABG in diabetics with severely impaired LV function. | [Pakistan Journal of Cardiology • 2006]

Author(s):

1. Malik Shahidi: King Faisal Sepcialist Hospital and Research Centre Riyadh, Saudi Arabia

2. H Hegazy: King Faisal Sepcialist Hospital and Research Centre Riyadh, Saudi Arabia

3. A Refaei: King Faisal Sepcialist Hospital and Research Centre Riyadh, Saudi Arabia

4. N. Elkum: King Faisal Sepcialist Hospital and Research Centre Riyadh, Saudi Arabia

5. Z. Al-Halees: King Faisal Sepcialist Hospital and Research Centre Riyadh, Saudi Arabia

Abstract:

Retrospective analysis of outcome of 28 patients who underwent coronary artery bypass graft surgery between November 2000 and October 2004 at King Faisal Specialist Hospital. All patients had severely impaired left ventricular function as indicated by preoperative echocardiogram. Myocardial viability was assessed using PET scanning before CABG. All segments of decreased perfusion and/or metabolism in the PET scan were re-analysed based on 18 segment model. All patients had post operative clinical evaluation and follow-up echocardiography for assessment of changes in LVEF as an indicator of global LV function. The mean age was 61 ± 11 years. Eighty-five percent were males, 44% had IDDM, and 56% with NIDDM, 63% had hypertension and 63% were with hyperlipidemia. Only 6 patients had prvious revascularization with percutaneous interventions. None of study patients had prior CABG. Mean preoperative left ventricular ejection fraction was 29 ± 9. Indication for surgery was severe angina in 74% of patients and refractory heart failure in the remaining 26%. Eighty-two percent of patients received >3 grafts. Mean hospital stay was 8.7 ± 4 days. Postoperative course was uneventful in 82% of patients. One patient died in postoperative phase from non cardiac causes. The remaining 27 patients were safely discharged home. Mean follow-up duration was 3.5 ± 1.6 years. Seventy-seven percent of patients remained asymptomatic. One patient had VT required ICD implantation. Five patients had ER visits but none required admission and no patient died during follow-up period. Postoperative LVEF improved to 40 ± 9 (P 4 hibernating myocardial segments had more significant improvement in LVEF compared to those with 4 viable segments identified patients who got the maximum improvement in LVEF.

Page(s): 16-24

DOI: DOI not available

Published: Journal: Pakistan Journal of Cardiology, Volume: 17, Issue: 1, Year: 2006

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