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Title Thallium-201 perfusion imaging with atrial pacing or dipyridamole stress testing for evaluation of cardiac risk prior to nonvascular surgery
Creator/Author Stratmann, H.G. ; Mark, A.L. ; Williams, G.A. (St. Louis Veterans Administration Medical Center, MO (USA))
Publication Date1990 Sep 01
OSTI IdentifierOSTI ID: 6216958
Other Number(s)ISSN0160-9289; CODEN: CLCAD
Resource TypeJournal Article
Resource RelationClinical Cardiology ; Vol/Issue: 13:9
Subject550601 -- Medicine-- Unsealed Radionuclides in Diagnostics; CARDIOVASCULAR DISEASES-- DIAGNOSIS;HEART-- SCINTISCANNING; EXERCISE;PATIENTS;PERFUSED ORGANS;RISK ASSESSMENT;THALLIUM 201;VASODILATORS
Related SubjectBETA DECAY RADIOISOTOPES;BODY;CARDIOVASCULAR AGENTS;CARDIOVASCULAR SYSTEM;COUNTING TECHNIQUES;DAYS LIVING RADIOISOTOPES;DIAGNOSTIC TECHNIQUES;DISEASES;DRUGS;ELECTRON CAPTURE RADIOISOTOPES;HEAVY NUCLEI;ISOMERIC TRANSITION ISOTOPES;ISOTOPES;NUCLEI;ODD-EVEN NUCLEI;ORGANS;RADIOISOTOPE SCANNING;RADIOISOTOPES;SECONDS LIVING RADIOISOTOPES;THALLIUM ISOTOPES
Description/Abstract Preoperative assessment of cardiac risk using thallium-201 scintigraphy and atrial pacing (n = 42) or dipyridamole stress testing (n = 35) was performed in 77 patients (mean age 65 +/- 7 years), who subsequently underwent elective nonvascular surgery.^All patients were at low cardiac risk by clinical criteria; none could perform exercise stress testing due to physical limitations.^ST depression consistent with ischemia occurred in 11 patients during atrial pacing and in 1 patient during dipyridamole stress testing (p less than 0.01).^Nine patients had reversible perfusion defects with atrial pacing, and 10 patients with dipyridamole stress testing; fixed defects were present in 15 and 8 patients, respectively.^Only one patient (fixed perfusion defect with atrial pacing, left main disease on coronary angiography) underwent preoperative coronary revascularization.^Two patients subsequently had postoperative cardiac events.^One patient (reversible perfusion defect with dipyridamole stress testing) experienced sudden death after a nonvascular procedure, while a second patient (normal thallium images with dipyridamole testing) had a nonfatal myocardial infarction.^In patients having atrial pacing or dipyridamole stress testing, thallium-201 scans that are normal or show only a fixed perfusion defect confirm a low risk of cardiac complications following nonvascular surgery.^The presence of a reversible perfusion defect does not preclude a postoperative course free of cardiac complications in patients at low cardiac risk by clinical criteria.
Country of PublicationUnited States
LanguageEnglish
FormatPages: 611-616
System Entry Date2001 May 13

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