Introduction and objectives: Conventional ergometry has limitations in the evaluation of coronary artery bypass graft patency. The aim of the present study was to determine the efficacy of exercise single photon emission tomography with 99mTc-compounds for the diagnosis of coronary artery bypass grafts disease.
Patients and methods: The state of sixty-seven coronary artery bypass grafts (31 with mammary artery, 36 with safein vein; 35 to left descending anterior artery, 15 to circumflex and 17 to right coronary artery) were analyzed retrospectively in 38 patients (mean age 63+/-8.7; 35 men). The time that elapsed between the coronary surgery and the exercise tomography was 9,7 years. In 16 cases, exercise tomography was performed with 99mTc-MIBI and in the 22 remaining with 99mTc-tetrofosmin. In 6 cases, dipiridamol was administred simultaneously during an insufficient exercise test.
Results: Sensitivity (73.1%), specificity (93%), positive predictive value (86.3%), negative predictive value (84.4%), global value (85%), positive likelihood ratio (10.4) and negative likelihood ratio (0.29) of exercise tomography were significantly (p<0.01) better than those obtained with the exercise test alone (53.8%, 43.6%, 38.9%, 58. 6%, 47.7%, 0.95 and 1.06, respectively).
Conclusions: Exercise tomography with 99mTc-compounds is a highly effective for the detection of coronary artery bypass grafts disease.