Abstract
Objective To explore clinic value of nuclear myocardiac perfusion imaging (MPI) in perioperative coronary risk assessment in patients with heart diseases planning arthroplasty, and compare the conformity and effect on surgery planning between MPI and coronary computed tomography angiogram (CTA). Methods Prospectively collect clinical data of 228 patients with heart diseases planning joint arthroplasty, all patients had MPI and CTA test to assess perioperative coronary risk. The conformity and effect on surgery planning between the MPI and CTA was analyzed, and the occurrence of cardio-vascular complication was recorded. Results MPI showed that 215 patients had no myocardial ischemia except for 13. CTA showed that 113 cases had no coronary stenosis, 51 cases had light coronary stenosis, 39 cases had middle coronary stenosis and 12 cases had severe coronary stenosis in patients with no myocardial ischemia. CTA also found that 3 cases had no coronary stenosis, 4 cases had light coronary stenosis, 3 cases had middle coronary stenosis and 3 cases had severe coronary stenosis in patients with myocardial ischemia. The conformity between MPI and CTA was low. 222 patients had completed operation except for 6 cases. MPI rather than CTA had conspicuous effect on surgery planning. There was no angina, myocardial infarction or cardiac death associated with myocardial ischemia. The postoperative cardio-vascular complications included 6 cases of heart failure, 4 cases of atrial fibrillation and 1 case of cerebral infarction. Conclusion MPI is a direct index to judge blood supply of the myocardium, which can exactly predict the risk of perioperative myocardial ischemia and the prognosis. It's helpful for preoperative planning, reducing risk of perioperative complications through screening and excluding high-risk patients. Key words: Arthroplasty, replacement; Myocardial perfusion imaging; Radioisotopes
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