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Objective: To study blood distribution in extracardiac total cavopulmonary connection (ETCPC). Methods: To combine a bidirectional cavopulmonary anastomosis with a Gore-Tex extracardiac conduit interposition between the inferior vena cava and the main pulmonary artery, and to evaluate the changes of pulmonary blood distribution with SPECT in all surviving patients. Results: The cournts of pulmonary radionuclide was (313.7?40.1)?10 3 increased significantly after surgery (t=2.23, P
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PURPOSE--To localize the site of the origin of sustained ventricular tachycardia in chronic chagasic cardiomyopathy patients refractory to antiarrhythmic therapy by radionuclide angiography techniques. METHODS--Five patients underwent radionuclide angiography by intravenous administration of 25mCi 99mTc. The images were obtained in sinus rhythm and during sustained ventricular tachycardia induced in the electrophysiologic laboratory for endocardial mapping. Amplitude and phase images were obtained resulting in a contraction wave synchronic to ventricular dispolarization. RESULTS--All patients had haemodynamic stability during the arrhythmia. One patient had incessant ventricular tachycardia. Mean ejection fraction was 0.38. In 4 patients the site of the origin of ventricular tachycardia was posterior and in one it was localized in the interventricular septum. There was identity in the site of the origin of ventricular tachycardia obtained by endocardial mapping or radionuclide angiography in all patients. The therapy was chemical ablation in 3 patients, surgical aneurysmectomy in one and pharmacologic therapy in the last patient. CONCLUSION--The site of the origin of ventricular tachycardia can be estimated by analyzing the contraction wave obtained by radionuclide angiography techniques in patients with hemodynamic stable sustained ventricular tachycardia.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Tachycardia, Ventricular , Chagas Cardiomyopathy , Electrophysiology , Radionuclide Angiography , Chronic DiseaseABSTRACT
ObjectiveTo evaluate the changes of portal vein pressure by (PVP) radionuclide imaging in cirrhotic patients undergoing portacaval shunt or esophageal transection-splenectomy.MethodThe radionuclide imaging was used to calculate portal pressure perioperatively in 15 shunt and 20 esophageal transection-splenectomy patients of portal hypertension.Results were compared with direct portal vein manometry.ResultPVP by manometry in portal hypertension patients 〔(37?4)?cm?H 2O〕 was very close to that calculated by preoperative imaging 〔(36?4)?cm?H 2O〕r=0.81,P
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BACKGROUND: A left to right shunt through an iatrogenic atrial septal defect(ASD) is known to occur after percutaneous mitral valvuloplasty(PMV), however, its hemodynamic significance as well as methods for the quantitation and follow-up evaluation have not been well established. SUBJECTS AND METHOD: In order to compare the feasibilities of noninvasive diagnostic methods for the detection and quantitation of the left-to-right shunt after PMV. 35 patients(age 37+/-10 years) undertook either radionuclide angiography or transesophageal echocardiography or both within a week after PMV. Qp/Qs was calculated by Fick's oxygen method during cardiac catheterization and by indicator dilution method during radionuclide angiography. The left-to-right shunt was also quantified with transesophageal echocardiography(TEE) by calculating shunt flow rate(Q=2 pir2Vr) using isovelocity surface area. RESULT: TEE was the most sensitive to detect ASD(16 among 27 patients, 59%) compared to either RI angiography(5 among 27 patients, 18%, Qp/Qs>1.5) or cardiac catheterization(4 among 35 patients, 11%, oxygen step-up>7%). Calculated shunt flow rate by TEE showed significant linear correlation to the Qp/Qs by cardiac catheterization(r=0.73, p<0.001). Also there was a significant correlation between Qp/Qs by radionuclide angiography and by cardiac catheterization(r=0.49, p<0.01). CONCLUSION: Both radionuclide angiography and TEE appear useful for the detection and quantitation of the left to right shunt after PMV. Since TEE seems to be not only more sensitive to detect the presence of the ASD than either radionuclide angiography or cardiac catheterization but useful to quantify the left-to-right shunt, it appears to be useful method for the follow-up evaluation after PMV.
Subject(s)
Humans , Cardiac Catheterization , Cardiac Catheters , Echocardiography, Transesophageal , Follow-Up Studies , Hemodynamics , Oxygen , Radionuclide AngiographyABSTRACT
Angiography has been playing important roles in diagnosis and treatment in the field of orthopaedic surgery. Conventional angiography is the most reliable and widely used method in diagnosis of peripheral arterial disease. But the clinical use of the conventional angiography has been limited by the risk of possible complications and time-consuming procedures. Radionuclide sngiography is rapidly performed, rapidly interpretable and time-saving procedure for the visualization of arterial tree prior to vascular intervention in the critically ill patient. We have analyzed and compared the 22 cases who had taken radionuclide angiography and conventional angiography simultaneously from November, 1986 to August, 1987 in Department of Orthopaedic Surgery, Hanysng University Hospital. The results were as follow 1. Radionuclide angiography is simple, non-invasive, accurste, reproducible method. It eliminstes the discomfort and morbidity of conventional angiography and can be done on an outpatient basis at a much lower cost. It is useful in the patients who may be allergic to the contrast medium. 2. In cases of arterial occlusion, radionuclide angiogrpahy is also useful in the evsluation of obstruction of major artery and can be substituted for conventionsl angiography. 3. For the purpose of evaluation of success in the cases of vascular reconstruction, radionuclide angiogrphy also demonstrate the vasculsr blood flow without any risk. 4. Although rsdionuclide angiography has limitstion in snatomic detsil, it could be psrtially substituted for conventionsl angiography in the diagnosis of vascular anomalies or tumors.