The value of dipyridamole thallium scintigraphy and dobutamine stress echocardiography as predictors of cardiac complications following reconstruction of the abdominal aorta

Background. The aim of this study was to evaluate the ability of dipyridamo le thallium scintigraphy and dobutamine stress echocardiography to predict cardiac complications following elective reconstruction of the abdominal ao rta in patients with a stable preoperative cardiac condition and to compare this with information obtained from the medical history, ECG and resting e chocardiography alone. Methods. This evaluation was performed from January 1993 until December 199 5 as part of a prospective, randomised study in 200 patients, with a mean a ge of 65 (5% women). Dipyridamole thallium scintigraphy was performed on 19 5 patients and dobutamine stress echocardiography was added to the protocol in the last 83 patients. Cardiac complications were defined before the sta rt of the study. Results. In the postoperative period 62 cardiac complications occurred (31% ). In patients clinically suspected of having coronary artery disease the i ncidence of complications was 40% (51/126), compared to 15% (11/74) when no coronary pathology was suspected (p<0.001). When reversible defects were p resent on dipyridamole thallium scintigraphy the incidence of complications was 36% (20/55), compared to 29% (41/140) when no reversible defects had b een found (NS). Dobutamine stress echocardiography was impossible or contra indicated in 21 patients. In the remaining patients the incidence of compli cations was 71% (5/7) when new regional wall motion abnormalities were foun d, compared to 16% (9/55) when such abnormalities had not been detected (p< 0.005). Conclusions. These data suggest that cardiac complications following recons truction of the abdominal aorta in patients with a stable cardiac condition are best predicted by dobutamine stress echocardiography. Dipyridamole tha llium scintigraphy, however, does not seem to be useful in this respect.