Skip to main content
NCBI home page
British Heart Journal logoLink to British Heart Journal
. 1980 Mar;43(3):270–275. doi: 10.1136/hrt.43.3.270

Dual isotope stress testing in congenital atresia of left coronary ostium. Applications before and after surgical treatment.

D Dymond, J Camm, D Stone, S Rees, G Rees, R Spurrell
PMCID: PMC482275  PMID: 7437174

Abstract

A 38-year-old women presented with an 11-year history of angina pectoris. Coronary arteriography disclosed a large right coronary artery which filled the entire left coronary tree retrogradely. The left main coronary artery ended blindly and was not connected to the aortic root. There were no atherosclerotic lesions in any vessel. Exercise thallium-20l scintigrams showed a perfusion defect in the anterior region of the left ventricle and exercise first pass radionuclide ventriculography showed anterior hypokinesis of the left ventricle with an ejection fraction of 54 per cent, compared with 60 per cent at rest. An aortocoronary saphenous vein graft was constructed to the left coronary artery. Four months after operation the patient is free from symptoms. Repeat thallium scintigrams were normal. Exercise radionuclide ventriculography after operation disclosed no wall motion abnormality, and ejection fraction on exercise was 70 per cent. The mechanism of angina in this patient is unclear but may have been related to the abnormal timing of delivery of blood to the left ventricular myocardium. Dual radionuclide stress testing showed abnormalities after operation. This non-invasive approach may be useful in the assessment of the physiological significance of coronary anomalies and of the value of corrective surgery.

Full text

PDF
270

Images in this article

271Image
on p.271
271Image
on p.271
272Image
on p.272
272Image
on p.272
273Image
on p.273
274Image
on p.274

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bailey I. K., Griffith L. S., Rouleau J., Strauss W., Pitt B. Thallium-201 myocardial perfusion imaging at rest and during exercise. Comparative sensitivity to electrocardiography in coronary artery disease. Circulation. 1977 Jan;55(1):79–87. doi: 10.1161/01.cir.55.1.79. [DOI] [PubMed] [Google Scholar]
  2. Bodenheimer M. M., Banka V. S., Fooshee C. M., Gillespie J. A., Helfant R. H. Detection of coronary heart disease using radionuclide determined regional ejection fraction at rest and during handgrip exercise: correlation with coronary arteriography. Circulation. 1978 Oct;58(4):640–648. doi: 10.1161/01.cir.58.4.640. [DOI] [PubMed] [Google Scholar]
  3. Chaitman B. R., Lespérance J., Saltiel J., Bourassa M. G. Clinical, angiographic, and hemodynamic findings in patients with anomalous origin of the coronary arteries. Circulation. 1976 Jan;53(1):122–131. doi: 10.1161/01.cir.53.1.122. [DOI] [PubMed] [Google Scholar]
  4. Cheitlin M. D., De Castro C. M., McAllister H. A. Sudden death as a complication of anomalous left coronary origin from the anterior sinus of Valsalva, A not-so-minor congenital anomaly. Circulation. 1974 Oct;50(4):780–787. doi: 10.1161/01.cir.50.4.780. [DOI] [PubMed] [Google Scholar]
  5. Dymond D. S., Jarritt P. H., Britton K. E., Spurrell R. A. Detection of postinfarction left ventricular aneurysms by first pass radionuclide ventriculography using a multicrystal gamma camera. Br Heart J. 1979 Jan;41(1):68–78. doi: 10.1136/hrt.41.1.68. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Finley J. P., Howman-Giles R., Gilday D. L., Olley P. M., Rowe R. D. Thallium-201 myocardial imaging in anomalous left coronary artery arising from the pulmonary artery. Applications before and after medical and surgical treatment. Am J Cardiol. 1978 Oct;42(4):675–680. doi: 10.1016/0002-9149(78)90640-9. [DOI] [PubMed] [Google Scholar]
  7. HELLERSTEIN H. K., LIEBOW I. M. Electrical alternation in experimental coronary artery occlusion. Am J Physiol. 1950 Feb;160(2):366–374. doi: 10.1152/ajplegacy.1950.160.2.366. [DOI] [PubMed] [Google Scholar]
  8. Jengo J. A., Oren V., Conant R., Brizendine M., Nelson T., Uszler J. M., Mena I. Effects of maximal exercise stress on left ventricular function in patients with coronary artery disease using first pass radionuclide angiocardiography: a rapid, noninvasive technique for determining ejection fraction and segmental wall motion. Circulation. 1979 Jan;59(1):60–65. doi: 10.1161/01.cir.59.1.60. [DOI] [PubMed] [Google Scholar]
  9. Jokl E., McClellan J. T., Williams W. C., Gouze F. J., Bartholomew R. D. Congenital anomaly of left coronary artery in young athletes. Cardiologia. 1966;49(5):253–258. doi: 10.1159/000168930. [DOI] [PubMed] [Google Scholar]
  10. KIRK E. S., HONIG C. R. NONUNIFORM DISTRIBUTION OF BLOOD FLOW AND GRADIENTS OF OXYGEN TENSION WITHIN THE HEART. Am J Physiol. 1964 Sep;207:661–668. doi: 10.1152/ajplegacy.1964.207.3.661. [DOI] [PubMed] [Google Scholar]
  11. Kimbiris D., Iskandrian A. S., Segal B. L., Bemis C. E. Anomalous aortic origin of coronary arteries. Circulation. 1978 Oct;58(4):606–615. doi: 10.1161/01.cir.58.4.606. [DOI] [PubMed] [Google Scholar]
  12. LAURIE W., WOODS J. D. SINGLE CORONARY ARTERY: A REPORT OF TWO CASES. Am Heart J. 1964 Jan;67:95–98. doi: 10.1016/0002-8703(64)90404-1. [DOI] [PubMed] [Google Scholar]
  13. Lenaers A., Block P., Thiel E. V., Lebedellr M., Becquevort P., Erbsmann F., Ermans A. Segmental analysis of Ti-201 stress myocardial scintigraphy. J Nucl Med. 1977 Jun;18(6):509–516. [PubMed] [Google Scholar]
  14. Maddox D. E., Holman B. L., Wynne J., Idoine J., Parker J. A., Uren R., Neill J. M., Cohn P. F. Ejection fraction image: a noninvasive index of regional left ventricular wall motion. Am J Cardiol. 1978 Jun;41(7):1230–1238. doi: 10.1016/0002-9149(78)90880-9. [DOI] [PubMed] [Google Scholar]
  15. Mullins C. E., el-Said G., McNamara D. G., Cooley D. A., Treistman B., Garcia E. Atresia of the left coronary artery ostium. Repair by saphenous vein graft. Circulation. 1972 Nov;46(5):989–994. doi: 10.1161/01.cir.46.5.989. [DOI] [PubMed] [Google Scholar]
  16. Murphy M. L. Single coronary artery. Am Heart J. 1967 Oct;74(4):557–561. doi: 10.1016/0002-8703(67)90016-6. [DOI] [PubMed] [Google Scholar]
  17. Ritchie J. L., Narahara K. A., Trobaugh G. B., Williams D. L., Hamilton G. W. Thallium-201 myocardial imaging before and after coronary revascularization: assessment of regional myocardial blood flow and graft patency. Circulation. 1977 Nov;56(5):830–836. doi: 10.1161/01.cir.56.5.830. [DOI] [PubMed] [Google Scholar]
  18. Sacks J. H. Saphenous vein bypass graft to left main coronary artery. Am J Surg. 1977 Aug;134(2):222–225. doi: 10.1016/0002-9610(77)90349-x. [DOI] [PubMed] [Google Scholar]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group

RESOURCES