Initial experience with myocardial perfusion scintigraphy (MPS) in patients awaiting lung volume reduction surgery (LVRS)

Full text: LVRS is an effective therapeutic option for patients with end-stage chronic airway limitation (CAL). Pre-operative cardiac assessment in such patients is vital for a favourable outcome. We reviewed the role of MPS in the pre-operative cardiac risk stratification of patients undergoing LVRS. Of 37 patients who underwent LVRS, 25 patients (11M/14F; mean age 59.9 yrs) were evaluated pre-operatively with a MPS. Two had a history of ischaemic heart disease. 17 patients were given dipyridamole (IV - 0.05mg/kg), and eight patients were given dobutamine (IV). The LVEF was determined in 11/25 patients (range - 54-79%, mean 65.5%). Reversible defects were reported in two patients; one involving the antero-lateral wall, confirmed with coronary catheterisation (C/C) (100% LAD lesion) and treated successfully with angioplasty, and 1 involving the inferior wall (false positive on C/C). Two fixed defects were reported, each involving the inferior wall and consistent with a history of prior inferior wall myocardial infarction. The post-operative course was favourable in all patients who had a MPS, except in one who died from sepsis, while another developed mild biventricular failure three months post-operatively. Both these patients had a normal MPS. In those who did not have a MPS study, 2/12 patients died in the post-operative period; one from sepsis (normal C/C), and the other from biventricular failure. No other cardiac complications were documented. Although the population size was small, MPS assisted in the pre-operative cardiac risk stratification and management of patients undergoing LVRS. Copyright (2000) The Australian and New Zealand Society of Nuclear Medicine Inc