Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Oct 2007
Case ReportsReverse-remodeling after coronary artery bypass grafting in ischemic cardiomyopathy: assessment of myocardial viability by delayed-enhanced magnetic resonance imaging can help cardiac surgeons.
Preoperative delayed-enhanced magnetic resonance imaging (DE-MRI) was performed to estimate myocardial viability in a 57-year-old man with ischemic cardiomyopathy in order to decide the best course of treatment. The patient was diagnosed as having congestive heart failure with triple-vessel involvement (ejection fraction of 7%, end-diastolic volume index of 160 ml/m2, end-systolic volume index of 148 ml/m2). 99mTc-sestamibi single-photon emission computed tomography revealed severe reduction of the uptake at both stress and resting phases in the anterior, lateral and inferior segments. ⋯ Six months after the operation, catheterization demonstrated dramatic improvement in ventricular function, with the ejection fraction having increased to 36%. This case suggests that preoperative assessment of myocardial viability by DE-MRI could help cardiac surgeons to choose the best treatment for patients with ischemic cardiomyopathy.