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Thallium-201 Myocardial Perfusion Scintigrams in the Evaluation of Aorto-Coronary Saphenous Bypass Surgery

University of Iowa and VA Hospitals, Iowa City, Iowa

Correspondence: ¹ For reprints contact: Melvin L. Marcus, Dept. of Internal Medicine, University of Iowa Hospitals, Iowa City, IA 52242.

ABSTRACT

The effect of aorto-coronary bypass graft surgery (CBG) upon regional myocardial perfusion (RMP) was studied in 23 patients using thallium-201 myocardial perfusing imaging after exercise. We compared the changes in RMP with the clinical status and ECG's during graded treadmill exercise (GTX) before and after CBG.

After CBG, the New York Heart Association's "functional class" improved from 3.2 ± 0.1 (mean ± SE) to 1.2 ± 0.2, p < 0.005. The GTX performance of the patients was also significantly improved postoperatively as judged by the total exercise time (11.7 ± 0.6 min postop, compared with 7.2 ± 0.5 min preop; p < 0.005).

Postoperative improved Tl-201 scintigrams were observed in 19 patients, but in only nine patients did the perfusion distribution return to normal. Thus, Tl.201 exercise scintigrams following CBG demonstrate improved RMP in most patients. Failure of regional myocardial perfusion to improve postoperatively, however, does not preclude marked alleviation of angina and improved exercise tolerance.

FOOTNOTES

^* Present Address: Dept. Int. Med., Baylor College of Medicine, Houston, TX 77030.

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