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SPECT
FOR THE DETECTION OF POST-INFARCTION LEFT |
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Shevtchenko Ju.
MD, Borisov I. MD, Pasha S., Bletkin A., Gorokhovatski Y., Vashkevich S. |
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OBJECTIVE: The “gold standard ” in diagnostics, as ventriculography, echocardiography, stress – echocardiography and SPECT (at rest and with dobutamine stress test), with the high degree of sensitivity detects left ventricular post-infarction aneurysm, its localization, presence of mitral regurgitation, helps in qualitative and quantitative evaluation of LV function in patients with post infarction left ventricular aneurysm. METHODS: In the present study we analyze data from complex clinical examination of 51 patients who have undergone the endoventricular circular autologous patch plasty repair and GABG since October 2000. Age of the patients ranged from 28-72 of years (average 49,5 years). In 27 cases the resection of an aneurysm was completed by GABG (mean number of bypass grafts - 2,34). Practically all patients were in 3-4 functional class (NYHA). RESULTS: On perfusion imaging alone, 24 patients had a significant amount of viable myocardium, whereas 27 patients did not. On the basis of the presence of viable dysfunctional myocardium, 24 of patients with chronic coronary artery disease and depressed left ventricular ejection fraction presenting with heart failure symptoms may be considered for coronary revascularisation. In 27 cases we performed the Dor procedure with autologous patch repair. In all cases aneurysmectomy was completed by GABG (mean number of bypass grafts - 2,2). Dynamic changes of parameters describing geometry, diastolic function and wall kinetics showed surgical remodeling to physiological shape of LV. CONCLUSION: The functional recovery of left ventricle performance as a result of surgical remodeling depends on the severity of myocardial dysfunction and adequacy of the operative method. |
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