대한핵의학회지 (1967년~2009년)
대한핵의학회지 1997;31(1)36~7
원저 : 관동맥우회로술 후에 심근 SPECT에 나타난 관류의 악화 분석 ( Analysis of Aggravated Perfusion in Myocardial SPECT after Coronary Artery Bypass Surgery )
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Author 이원우 , 이동수 , 윤석남 , 김기봉 , 정준기 , 이명철 , 고창순 ( Won Woo Lee , Dong Soo Lee , Seok Nam Yoon , Ki Bong Kim , June Key Chung , Myung Chul Lee , Chang Soon Koh ),
Affiliation
Abstract

Though myocardial perfusion was usually expected to improve after coronary artery bypass graft(CABG) surgery, some myocardial segments were aggravated after operation, as we compared perfusion changes on postoperative SPECT with preoperative ones. In this study, we evaluated perfusion changes after operation in rest and stress myocardial SPCET in 44 patients (M:F=25:19, age 57.1 year +- 8.2) who had CABG before and 3 months after operation. We tried to find out possible causes for perfusion aggravation with multivariate logistic regression analysis regarding whether bypass graft was artery or vein and which coronary artery territory was operated. Among 616 myocardial segments which were operated, 89(14.4%) aggravated after operation In the univariate analysis, myocardial segments in the left circumflex arteries(I Cx) aggravated more often(p<0.01) than others and segments having operative angioplasty did less often(p<0.01). Multivariate logistic regression revealedthat LCx was risk factor for perfusion aggravation [odds ratio=2.54 (95% confidence interval : 1.53-4.22, p<0.01)] However, this was not the case when we analysed in terms of arterial territories. Among 106 coronary rterial territories which were operated. 27(25.5%) aggravated. The territories having aggravated had similar characterstics regarding whether they received arterial or venous grafts. Angioplasty and whether the operated territories were left anterior descending. Right coronary or left circumflex arteries. In conclusion, myocardial segments in the left circumflex artery tended to aggravate more often after bypass surgery than the others. In short-term comparison of perfusion after surgery. We could not find any tendency that arterial or venous fraft was associated with more frequency of the affravation of perfusion after operation.

Keyword Aggravated perfusion, Myocardial SPECT, Cornary artery bypss
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