Hostname: page-component-848d4c4894-cjp7w Total loading time: 0 Render date: 2024-07-04T14:54:58.687Z Has data issue: false hasContentIssue false
  • English
  • Français

Myocardial perfusion scanning in patients considered for late arterial switch

Published online by Cambridge University Press:  19 August 2008

Karen A McLeod ,
Joseph De Giovanni ,
Eric Silove ,
Helen Alton ,
Robert Poyner  and
William Brawn
Karen A McLeod*
Affiliation:
Royal Hospital for Sick Children, Glasgow, UK
Joseph De Giovanni
Affiliation:
Heart Unit, Birmingham Children's Hospital
Eric Silove
Affiliation:
Heart Unit, Birmingham Children's Hospital
Helen Alton
Affiliation:
Department of Nuclear Cardiology, University Hospital NHS Trust, Birmingham;
Robert Poyner
Affiliation:
Department of Nuclear Cardiology, University Hospital NHS Trust, Birmingham;
William Brawn
Affiliation:
Heart Unit, Birmingham Children's Hospital
*
Dr KA McLeod, Royal Hospital for Sick children, Yorkhill NHS Trust, Glasgow, G3 8SJ, UK. Tel: 0141 201 0246; Fax: 0141 201 0853
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Our aims were to evaluate left ventricular uptake of radionuclide in patients with Mustard's or Senning's procedure, comparing them with patients who had undergone banding of the pulmonary trunk and conversion to the arterial switch.

Methods

Technetium perfusion scans were performed on 27 patients (25 male), aged from 10 to 28 years with a mean of 17.8 years and a standard deviation of 5.8 years, who had undergone Mustard's or Senning's procedure for correction of complete transposition. Of the 27 patients, six had been accepted for staged conversion to an arterial switch. At the time of the study, two of the six patients had undergone completion to the switch and four had undergone banding of the pulmonary trunk with two then proceeding to the arterial switch. Cardiac catheterisation to measure left ventricular pressure was performed in all six patients and scores for left ventricular uptake of isotope were compared with echocardiographic index of the thickness of the left ventricular posterior wall and measure ments of left ventricular pressure.

Results

Uptake of isotope by the left ventricle was generally poor, but was higher in patients following banding and conversion to the arterial switch, as well as in two patients with native obstruction of the left ventricular outflow tract, and one other who subsequently was found to have pulmonary venous obstruction. There was a positive correlation between the thickness of the left posterior wall in diastole and left ventricular uptake of isotope (r = 0.74, p< 0.05). There also a positive correlation between left ventricular pressure and uptake of the isotope (r = 0.68, p<0.05).

Conclusions

Uptake of radionuclide by the left ventricle after Mustard's or Senning's procedure for complete transposition appears to reflect ventricular pressure and myocardial mass. A prospective study would be required to determine the predictive ability of such scans regarding the ultimate outcome of conversion to arterial switch, but our initial findings suggest that the technique provides an additional non-invasive method of monitoring left ventricular response to pulmonary arterial banding.

Keywords

radionuclidetransposition of the great arteriespulmonary bandingarterial switch
Type
Original Articles
Information
Cardiology in the Young , Volume 10 , Issue 1 , January 2000 , pp. 21 - 26
Copyright
Copyright © Cambridge University Press 2000

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Kato, H, Nahono, S, Mostada, H, Hirose, H, Shimazaki, Y, Kawashima, Y. Right ventricular myocardial function after atrial switch operation for transposition of the great arteries. Am J Cardiol 1989; 63: 226–230.CrossRefGoogle ScholarPubMed
2.Graham, TP jr, Atwood, GF, Bowcek, RJ, Boerth, RC, Bender, HW. Abnormalities of right ventricular function following Mustard's operation for transposition of the great arteries. Circulation 1975; 52: 678–684.CrossRefGoogle ScholarPubMed
3.Hurwitz, RA, Cauldwell, RL, Girod, DA, Brown, J. Right ventricular systolic function in adolescents and young adults after Mustard operation for transposition of the great arteries. Am J Cardiol 1996; 77: 294–297.CrossRefGoogle Scholar
4.Bender, HW JrSteward, JR, Merrill, WH, Hammon, JW Jr, Graham, TP Jr. Ten years experience with the Sennings operation for transposition of the great arteries; physiological results and late follow-up. Ann Thorac Surg. 1989; 47: 218–223.CrossRefGoogle Scholar
5.Mee, RBB, Arterial switch for right ventricular failure following Mustard or Senning operations. In: Stark, J, Pacifico, A, eds. Reoperation in cardiac surgery. Springer-Verlag. Heidelberg. 1989: 217–232.CrossRefGoogle Scholar
6.Cochrane, AD, Karl, TR, Mee, RBB. Staged conversion to arterial switch for late failure of the systemic right ventricle. Ann Thorac Surg 1993; 56: 854–862.CrossRefGoogle ScholarPubMed
7.Bonow, RO, Dilsizian, V. Tallium–201 and technetium–99msestamibi for assessing myocardial viability. J Nucl Med 1992; 33: 815–818.Google Scholar
8.Beller, GA, Rogasta, M, Watson, DD, Gimple, LW. Myocardial Thallium–201 scintigraphy for assessment of myocardial viability in patients with severe left ventricular dysfunction. Am J Cardiol 1992; 70: 18E–22E.CrossRefGoogle ScholarPubMed
9.American College of Cardiology, American Heart Association, Society of Nuclear Medicine Policy Statement. Standardisation of cardiac tomographic imaging. Circulation 1992; 86: 338–339.Google Scholar
10.Hayes, AM, Baker, EJ, Kakadeker, A, Parson, JM, Martin, RP, Radley-Smith, R, Qureshi, SA, Yacoub, M, Maisley, MN, Tynan, M. Influence of anatomic correction for transposition of the great arteries on myocardial perfusion. Radionuclide imaging with technetium–99m –2-methoxy isobutyl isonitrile. J Am Coll Cardiol 1994; 2493): 769–777.CrossRefGoogle Scholar
11.Labbe, L, Douard, H, Barat, J, Broustet, JPBordenave, L et al. Alteration of myocardial viability and systemic ventricular dysfunction after the Senning procedure. Arch Mal Coeur Vaiss. 1997; 90: 631–637.Google ScholarPubMed
12.Lundstrom, U, Bull, C, Wyse, RKH, Somerville, J. The natural and ‘unatural’ history of congenitally corrected transposition. Am J Cardiol 1990: 65 (18): 1222–1229.CrossRefGoogle Scholar
13.Mee, RBB. Severe right ventricular failure after Mustard or Senning operation. Two stage repair: pulmonary artery banding and switch. J Thorac Cardiovasc Surg 1986; 92: 385–390.CrossRefGoogle ScholarPubMed
14.Leppo, JA, Johnson, LL. A review of cardiac imaging with setstamibi and teboroxime. J Nuci Med 1991; 32: 2012–2022.Google ScholarPubMed
15.Melon, PG, Beanlands, RS, DeGrado, TR, Nguyen, N, Petry, NA, Schwaiger, M. Comparison of technetium–99m sestamibi and thallium–201 retention characteristics in canine myocardium. J Am Coll Cardiol 1992; 20: 1277–1283.CrossRefGoogle ScholarPubMed
16.De-Puey, EG, Jones, ME, Garcia, EV. Evaluation of right ventricular regional perfusion with technetium–99m setsamibi SPECT. J Nucl Med 1991; 31: 1199–1205.Google Scholar
17.Williams, WG, Quaegebeur, JM, Kirklin, JW, Blackstone, EH, Hanley, FL, Anagnostopoulos, CE, Lacour-Gayet, F. Outflow obstruction after the arterial switch operation: A multi institu tional study. J Thorac Cardiovasc Surg 1997; 114: 975–990.CrossRefGoogle Scholar