Assessment of CABG-related risk in patients with CAD and LVD - Contribution of PET with [F-18]FDG to the assessment of myocardial viability

Background. Previous studies have demonstrated that hibernating myocardium can be assessed by [F-18]fluorodeoxyglucose ([F-18]FDG) and positron emissi on tomography (PET). This study evaluated the use of[F-18]FDG-PET for CABG related risk assessment in patients with coronary artery disease (CAD) and left ventricle dysfunction (LVD). Methods. We retrospectively evaluated 241 to patients candidate CABG presen ting with signs and symptoms of congestive heart failure (CHF) prevailing o ver ischemic signs. Of the 241 patients, 153 had undergone [F-18]FDG-PET as well. as conventional assessment: 110 out of 153 (group A) were operated b ecause of PET evidence of hibernation. Of the 241 patients, 88 had not unde rgone [F-18]FDG-PET: 86 out of 88 (group B) were operated on The outcome of surgical patients was evaluated by considering all major perioperative com plications including the use of mechanical and pharmacological support and in-hospital mortality. After hospital discharge, each patient was examined at 1, 4 and every 4 months thereafter. Results. Perioperative use of mechanical supports and inotropic drugs, was significantly lower for the PET selected group (A) than for the non PET sel ected group (B), Mortality within 30 days of surgery was 0.9% in group A an d 19.8% in group B. The only predictors of perioperative outcome were the p resence of hibernating tissue and the ejection fraction. Conclusions. [F-18]FDG-PET prior to CABG can be crucial for the assessment of perioperative risk in patients with CAD.