Identification of recurrent ischemia after coronary artery bypass surgery: a comparison of positron emission tomography and single photon emission computed tomography

doi:10.1016/0167-5273(92)90052-5

International Journal of Cardiology

Volume 35, Issue 1, April 1992, Pages 33-41

https://doi.org/10.1016/0167-5273(92)90052-5 Get rights and content

Abstract

Current techniques for the detection of recurrent coronary stenoses following bypass grafting have shown disappointing diagnostic accuracy. This study used the same dipyridamole-handgrip stress to compare the accuracy of rubidium-82 positron emission tomography and thallium-201 single photon emission computed tomography, in 50 consecutive post-bypass patients undergoing coronary arteriography at a mean interval of 6.5 years after surgery. Significant stenoses in native coronary vessels (> 50% diameter) or grafts (> 70% diameter) were defined by quantitative angiography. Forty-six patients had recurrent or residual stenoses, 43 (93%) had a perfusion defect identified by positron emission tomography, and 35 (76%) were identified by single photon emission computed tomography (P = 0.04). Fourteen of the 17 patients (82%) without previous Q-wave myocardial infarction were identified by positron emission tomography; 10 of the 17 (59%) were detected by single photon emission computed tomography (P = NS). Stress-induced perfusion defects were demonstrated by positron emission tomography in 19 patients; of this group, thallium imaging identified reversible defects in 11, showed no perfusion defect in 1, and portrayed a persistent defect in 7 patients. Significant graft disease was present in 33 patients; perfusion defects were identified by positron emission tomography in 30 (91%), and by single photon emission computed tomography in 24 (73%, P = NS). Four patients were fully revascularized, without significant recurrent coronary disease; normal perfusion was present in 3 (75%) by positron emission tomography, and 4 (100%) by single photon emission computed tomography. Myocardial perfusion imaging using positron emission tomography has a high accuracy for the detection of both graft and native vessel disease, and may be useful in the non-invasive follow-up of patients following coronary artery bypass grafting.

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^☆: Presented in part at the 12th Congress of the European Society of Cardiology, Stockholm, Sweden, August 1990.

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Original studyIdentification of recurrent ischemia after coronary artery bypass surgery: a comparison of positron emission tomography and single photon emission computed tomography☆

Abstract

Am J Cardiol

Chest

Am J Cardiol

J Am Coll Cardiol

Cardiol Clin

J Am Coll Cardiol

Am J Cardiol

Am J Cardiol

Treatment of chronic stable angina: a preliminary report of survival data in the randomized Veterans Administration cooperative Study

N Engl J Med

Coronary artery bypass surgery in stable angina pectoris: survival at two years

Lancet

National Heart, Lung and Blood Institute Coronary Artery Surgery Study

Circulation

Aortocoronary saphenous vein bypass grafts: long-term patency, morphology and blood flow in patients with patent grafts early after surgery

Circulation

Long-term clinical outcome of coronary surgery and assessment of the benefit obtained with post-operative aspirin and dipyridamole

Br Heart J

Thallium-201 myocardial imaging in assessment of results of aortocoronary bypass surgery

Br Heart J

Thallium-201 exercise myocardial imaging to evaluate myocardial perfusion after coronary artery bypass surgery

Br Heart J

Exercise thallium-201 myocardial scintigraphy in the follow-up of aortocoronary bypass graft surgery

Br Heart J

Original study
Identification of recurrent ischemia after coronary artery bypass surgery: a comparison of positron emission tomography and single photon emission computed tomography☆