Myocardial viability and revascularization surgery

Full text: : To evaluate the contribution of the myocardium viability study with Thallium-210, after acute myocardial infarction (AMI), in the results of the myocardial revascularization surgery (CABG) in patients with severe compromising of the left ventricular function and without evidence of residual ischemia. Retrospective study of 310 patients (P) submitted to CABG between January 1994 to June 1996. From these, 14 (10 male, 71,4%) with average of 60,2 years old (39-73), with AMI antecedent, severe illness of 3 blood vessels, ejection fraction (EF) lower to 30%, viability in the isotopic study and absence of residual ischemia. All the patients made radionuclide angiography, more or less 1 month before 4 and 6 months after the surgery. We compared the obtained EF values and considered statistically significant the value of p<0,05. 3 by-pass were, in media, implanted, being used in everybody the pedicled left internal mammary artery for the anterior descendent artery. In 3 patients were also used the right internal mammary artery. The media value of the EF were of 21,5 + 5,9% (11 a 29%) before the surgery and of 36,7 + 8,5% (26-50%) 4 to 6 months after (p=0,003). In patients with severe coronary illness, low EF and without evidence of ischemia, the viability existence of the isotopic study allows us to identify the patients that probably were more benefited by the surgical treatment