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Thorac Cardiovasc Surg 1983; 31(1): 16-20
DOI: 10.1055/s-2007-1020285
© Georg Thieme Verlag Stuttgart · New York

Long-term Follow-up of Patients with Valve Replacement for Chronic Mitral Insufficiency using Technetium-99m-Pertechnetate Scintigraphy

A. Welz, B. Reichart, W. Klinner, N. Schad1 , G. Bougioukas, J. Weingartner, P. Überfuhr
  • Department of Cardiac Surgery, University of Munich, FRG
  • 1Community Hospital, Passau, FRG
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Publication History

Publication Date:
19 March 2008 (online)

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Summary

Technetium-99m-Pertechnetate scintigraphies (first pass technique) were performed on 9 men and 3 women (age at operation 48 ± 13 years) at an average of 19.8 ± 11 months after valve replacement for chronic mitral insufficiency.

Preoperative left ventriculography showed increased enddiastolic and endsystolic volumes (230.9 ± 66 and 73.5 ± 26 ml respectively). Part of the stroke volume, 59.4 ± 9% (1 57.5 ± 47 ml), regurgitated into the left atrium. The ejection fraction was normal in all cases (67.7 ± 6%).

Radionuclide ventriculograms of the right and left ventricles were taken and postoperative enddiastolic and endsystolic volumes calculated according to an experimentally derived formula. The patients were examined both at rest and after age-related maximum exercise.

Enddiastolic and endsystolic volumes of the left ventricle were normal at rest 19.8 ± 11 months postoperatively (121.8 ± 38 and 52.8 ± 35 ml respectively) and after peak exercise (122.0 ± 29 and 37.6 ± 22 ml respectively). The ejection fraction responded physiologically to exercise by increasing from 57.7 ± 12% to 69.7 ± 10% (p < 0.05). Volumes and ejection fraction of the right ventricles were within normal range both at rest and after exercise.

After peak exercise, the mean rapid filling rate increased from 211.9 ± 50 ml/sec to 433.4 ± 178.1 ml/sec. The pulmonary transit time measured 7.3 ± 1.2 seconds at rest and 4.4 ± 1.2 seconds after exercise. Both parameters revealed physiologic functioning of the implanted valve prostheses (10 Björk-Shiley and 2 Carpentier-Edwards). According to the reported data, valve replacement for chronic mitral insufficiency is able to normalize left ventricular function. Non-invasive Technetium-99m-Pertechnetate scintigraphy appears particularly suitable for evaluating left ventricular function after mitral valve replacement.

Key words

Chronic mitral insufficiency - First pass technique

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