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Rivista di Angiologia

Official Journal of the International Union of Angiology, the International Union of Phlebology and the Central European Vascular Forum
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International Angiology 1999 June;18(2):158-62

lingua: Inglese

Role of dip­y­rid­a­mole myo­car­dial scin­tig­ra­phy in abdom­i­nal aortic aneu­rysm ­repair

Matsumoto K., Nakamaru M., Obara H., Hayashi S., Harada H., Kitajima M.

From the Depart­ment of Sur­gery, Keio Uni­ver­sity ­School of Med­i­cine, Tokyo, Japan


Background. We eval­u­at­ed the use­ful­ness of pre­op­er­a­tive dip­y­rid­a­mole myo­car­dial scin­tig­ra­phy (DMS) under low-level exer­cise in pre­dict­ing post­op­er­a­tive car­diac prob­lems in ­patients under­go­ing elec­tive abdom­i­nal aor­tic aneu­rysm (AAA) ­repair.
Methods. Experi­men­tal ­design: ret­ro­spec­tive com­par­i­son of ­patients who did and did not under­go the investigation pre­op­er­a­tive­ly. Set­ting:­ at the Keio Uni­ver­sity Hos­pi­tal and the Kawa­sa­ki City Hos­pi­tal. ­Patients: ­eighty-five ­patients who had abdominal aortic aneurysm ­repair con­sec­u­tive­ly from 1986 to 1990 with­out under­go­ing dipyridamole myocardial scintigraphy pre­op­er­a­tive­ly were com­pared with 118 ­patients who under­went the ­repair con­sec­u­tive­ly from 1991 to 1997 after hav­ing had pre­op­er­a­tive scintigraphy.
Meas­urements: post­op­er­a­tive occur­renc­es of myo­car­dial infarc­tion and angi­na pec­tor­is in the two ­groups of ­patients were com­pared sta­tis­ti­cal­ly.
­Results. In the group not hav­ing scintigraphy, car­diac ­events ­occurred in 12 pa­tients (14.1%) after ­repair. Ten ­patients had a myo­car­dial infarc­tion; six died with­in 30 days of oper­a­tion and four died after the 31st post­op­er­a­tive day. The other two ­patients had angi­na pec­tor­is; both sur­vived. In the group hav­ing scintigraphy, there were no post­op­er­a­tive car­diac ­events (p<0.0001). Sev­en­teen ­patients had pos­i­tive ­results on pre­op­er­a­tive scintigraphy. Seven of them had undergone cor­o­nary ­artery ­bypass graft­ing and five cor­o­nary angio­plas­ty ­before the ­repair. In the five other ­patients, scintigraphy, was found to have yield­ed false pos­i­tive ­results.
Con­clu­sions. Dypiridamole myocardial scintigraphy is an accu­rate pre­dic­tor of post­op­er­a­tive myo­car­dial infarc­tion and angi­na pec­tor­is in ­patients being eval­u­at­ed for elec­tive abdominal aortic aneurysm repair and ­should be used rou­tine­ly.

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