The Annals of Thoracic Surgery, Vol 21, 311-317, Copyright © 1976 by The Society of Thoracic Surgeons
Technetium stannous pyrophosphate myocardial scintigrams in the recognition of myocardial infarction in patients undergoing coronary artery revascularization
MR Platt, RW Parkey, JT Willerson, FJ Bonte, W Shapiro and WL Sugg
Myocardial imaging using technetium 99m stannous pyrophosphate (99mTc- PYP)
has been utilized preoperatively and three to five days postoperatively to
detect myocardial infarction in 48 patients undergoing aortocoronary bypass
grafting, including 7 having valve replacement (5 aortic, 2 mitral) in
addition to revascularization. In the total group of patients operated on
there were 3 deaths (6%). Preoperatively, 26 patients had unstable angina
and 10 had severe left main coronary artery disease. Eleven of the 48 (23%)
were women. ECG and enzyme-proved infarctions occurred in 6 of the 48
patients (12%), but the addition of 99mTc-PYP myocardial imaging
demonstrated scintigraphic evidence of infarction in 15 patients (31%),
including 2 who died in the operating room. The 99mTc-PYP myocardial
imaging technique, which has proved safe, simple, and relatively
inexpensive in these patients, suggests that the incidence of infarction
after coronary bypass operations is somewhat higher than has been
previously recognized from just ECG and enzyme changes. This technique also
has been of value in helping to exclude myocardial infarction in difficult
clinical situations such as postoperative arrhythmias and the
postpericardiotomy syndrome.
