Dual isotope stress testing in congenital atresia of left coronary ostium. Applications before and after surgical treatment.
Key result
Aortocoronary saphenous vein grafting in a 38-year-old woman with congenital atresia of the left coronary ostium resolved angina symptoms and normalized dual radionuclide stress testing at 4 months.
Why the study?
Does aortocoronary bypass surgery improve symptoms and myocardial perfusion in a patient with congenital atresia of the left coronary ostium?
Population
1 38-year-old woman with an 11-year history of angina pectoris and congenital atresia of the left coronary…
Comparison
Aortocoronary saphenous vein graft to the left… vs Pre-operative state
Design
Case_report
Follow-up
4 months
Authors
Discussion
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Implication
May support grafting for angina in rare coronary ostial atresia; leaves open need for confirmatory studies.
Key Points
- This study aims to evaluate the effectiveness of dual isotope stress testing in assessing coronary function in a patient with congenital left coronary ostium atresia before and after surgery.
- Conducted dual radionuclide stress testing and thallium scintigrams pre- and post-operatively.
- Used aortocoronary saphenous vein grafting for surgical intervention.
- Measured ejection fractions and wall motion abnormalities pre- and post-surgery.
- Before surgery, ejection fraction was 54% during exercise testing, with anterior hypokinesis noted.
- Post-surgery, ejection fraction improved to 70% during exercise without wall motion abnormalities.
- Normal thallium scintigrams post-operative indicate resolved perfusion defects.
Study Design
Type
Case Report (n=1)
Structured PICO
Does aortocoronary bypass surgery improve symptoms and myocardial perfusion in a patient with congenital atresia of the left coronary ostium?
P
Population
A 38-year-old woman with an 11-year history of angina pectoris and congenital atresia of the left coronary ostium, evaluated before and 4 months after surgical treatment.
I
Intervention
Aortocoronary saphenous vein graft to the left coronary artery, assessed by dual isotope stress testing (thallium-201 scintigraphy and first pass radionuclide ventriculography).
C
Comparator
Pre-operative state
O
Outcome
Symptom resolution and improvement in myocardial perfusion and ventricular function on dual isotope stress testingsurrogate
Dual radionuclide stress testing effectively demonstrated the physiological significance and successful surgical correction of congenital left coronary ostial atresia.
Cite This Study
Dymond et al. (1980) conducted a case report in Congenital atresia of left coronary ostium (n=1). Aortocoronary saphenous vein graft vs. Pre-operative state was evaluated on Symptoms and dual radionuclide stress testing abnormalities. Aortocoronary saphenous vein grafting in a 38-year-old woman with congenital atresia of the left coronary ostium resolved angina symptoms and normalized dual radionuclide stress testing at 4 months.