PUMA
Istituto di Fisiologia Clinica     
De Maria R., Repossini A., Dabdoob W., Parolini M., Cianci V., Bestetti A., Binetti G., Arena V., Parodi O. Myocardial perfusion imaging evidence of functionally complete revascularization by minimally invasive direct coronary artery bypass in 2-vessel coronary artery disease. In: Journal of Nuclear Cardiology, vol. 14 pp. 860 - 868. Elsevier, 2007.
 
 
Abstract
(English)
Background. Whether patency of a second diseased vessel still impacts myocardial perfusion when complete revascularization of the left anterior descending coronary artery (LAD) territory has been achieved is currently undetermined. In patients with 2-vessel coronary artery disease and complex LAD lesions, we evaluated the impact of single LAD or integrated revascularization on single photon emission computed tomography-assessed reversible myocardial ischemia. Methods and Results. Thirty-five candidates for revascularization with double-vessel disease including the LAD and a preoperative stress single photon emission computed tomography study were studied. Revascularization was performed by minimally invasive direct coronary artery bypass (MIDCAB) alone (n = 15) or by an integrated procedure with second-vessel angioplasty, either soon after surgery (n = 13) or at 2 months (n = 7), according to the extent of reversible perfusion defects in the second vessel territory. At 1 year, the total ischemic area decreased from 9.3 5.1 to 0.8 1.5 in MIDCAB-only patients and from 8.2 4.9 to 1.6 2.9in the integrated group (P =.87 for treatment and P < .001 for time). The ischemic area in the second vessel territory similarly decreased in both groups (P = .81 for treatment and P < .001 for time). Conclusions. In 2-vessel coronary artery disease involving the LAD, MIDCAB alone achieves, in a substantial proportion of patients, functionally complete revascularization even in the nonrevascularized second vessel territory.
Subject Myocardial perfusion imaging
Coronary artery disease
Myocardial ischemia


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