Scintigraphy after Various Methods of Myocardial Revascularization

Abstract. This article presents a comprehensive assessment of the perfusion-functional state of the LV myocardium after direct and indirect revascularization methods at various times after surgery to evaluate the complex relationship between myocardial viability and the method of revascularization. The research shows a significant advantage to using the YurLeon method of inducing extracardial revascularization of the myocardium in patients with diffuse coronary lesions. Aim. Comparative dynamic of scintigraphic indicators with various methods of revascularization. Materials and Methods.The study included 214 patients who underwent myocardial revascularization in various ways. Gated-SPECT was performed before the operation, as well as 1 month, 6 months, 1 year, and 2 or more years after the operation. Results.The groups of patients after CABG and CABG+YurLeon had differences in SRS indicators one year after surgery: 6.58±7.37 (after CABG) and 1.01±1.49 (CABG+YurLeon)(p<0.05).The most significant changes in systolic thickening (WT) occurred in segments with an accumulation of 26-40%: 1.78±1.84 (CABG), 0.51±0.85 (CABG+YurLeon), 2.6±1.19(PCI); and in segments 41-50%: 1.23±1.10 (CABG), 0.14±0.39 (CABG+YurLeon), 2.1±0.8 (PCI) (p<0.05).In the long-term period after revascularization, the total percentage of LV myocardial segments with "functional-perfusion mismatch" stood at: 11.08±11.69% of segments (CABG), 1.26±2.7% (CABG+YurLeon), 18.44±8.70% (PCI) (p<0.05). Conclusion. Comprehensive diagnostics of patients before surgery, including gated-SPECT, allow medical professionals to more effectively choose the method of revascularization and predict the nearest and separated results. Coronary bypass surgery together with the YurLeon technique of indirect myocardial revascularization in patients with severe diffuse lesions of the coronary artery shows more effective results than other methods of surgically treating IHD.