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Canadian Journal of Anaesthesia

, Volume 37, Issue 4, pp 409–415 | Cite as

Dipyridamole-thallium myocardial scanning in the pre-operative assessment of patients undergoing abdominal aortic aneurysmectomy

  • Raymer P. Grant
  • Cliff Morgan
  • Michael S. Page
  • David N. Malm
  • Victor Huckel
  • Leonard C. Jenkins
Reports of Investigation

Abstract

Dipyridamole thallium scanning (DTS) is an imaging technique with good sensitivity for coronary artery disease (CAD). The purpose of this study was to compare the haemodynamic courses and the correlation between pulmonary capillary wedge pressure (PCWP) and central venous pressure (CVP) in patients with normal DTS (Group 1: n = 12) with those whose scans demonstrated CAD (Group2: n = 11). Haemodynamic profiles were obtained prior to anaesthesia and at several times during surgery. The haemodynamic courses in both groups were similar with significant decreases in cardiac index, stroke index, and left ventricular stroke work index during aortic cross-clamping compared with values prior to anaesthesia. There were no significant changes in PCWP and CVP throughout the study. The correlations between PCWP and CVP were significant in both groups as were the correlations between the changes in PCWP and the changes in CVP observed at the time of cross-clamping. These correlations all had large standard errors of the estimate, however, making it impossible to predict the PCWP from the CVP with precision. It is concluded that, in a limited study population, an abnormal DTS did not identify patients in whom the PCWP and CVP correlated poorly during abdominal aortic aneurysmectomy.

Key words

anaesthesia: cardiovascular heart: assessment, ischaemia measurement techniques: pulmonary arterial, thallium-radionuclide imaging, venous pressure monitoring: vascular surgery: vascular, aortic 

Résumé

La scintigraphie myocardique au thallium et dipyridamole (SMTD) est un outil diagnostique sensible à la présence de maladie coronarienne. Nous avons comparé le profil hémodynamique et la corrélation entre la pression bloquée de l’artère pulmonaire (PCWP) et la tension veineuse centrale (CVP) chez deux groupes de candidats à une résection d’anévrysme de l’aorte abdominale. Dans le groupe 1 (n = 12), les SMTD étaient normales tandis que dans le groupe 2 (n = 11) elles suggéraient une coronaropathie. Lorsqu’on les comparait aux valeurs pré-anesthésiques, les indices de débit cardiaque, de volume d’éjection et de travail ventriculaire gauche des deux groupes diminuaient lors du clampage aortique, sans changement significatif de PCWP ou de CVP. On a pu établir une corrélation significative entre PCWP et CVP de même qu’entre les changements de ces variables survenant lors du clampage. Toutefois, la grande variance résiduelle de ces corrélations empêchait de prédire avec précision la PCWP à partir de la CVP. Done, dans cette étude sur un petit nombre, la SMTD n’a pu identifier les patients chez qui PCWP et CVP étaient dissociées lors d’une résection d’anévrysme de l’aorte abdominale.

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Copyright information

© Canadian Anesthesiologists 1990

Authors and Affiliations

  • Raymer P. Grant
    • 1
  • Cliff Morgan
    • 1
  • Michael S. Page
    • 1
  • David N. Malm
    • 1
  • Victor Huckel
    • 1
  • Leonard C. Jenkins
    • 1
  1. 1.Department of Anaesthesiology and Division of Cardiology, Faculty of MedicineUniversity of British Columbia and Vancouver General HospitalVancouver

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