Valve Replacement for Chronic Mitral Insufficiency; Long-term Follow up Using Technetium Pertechnetate Scintigraphy

Abstract

Technetium Pertechnetate Scintigraphy was performed in 12 patients (9 men and 3 women, average age 48 ± 13 years) on an average 19.8 ± 11 months after valve replacement for chronic mitral insufficiency. Preoperative conventional ventriculography had revealed increased enddiastolic and endsystolic volumes (230.9 ± 66 resp. 73.5 ± 26 ml). 59.4 ± 9% of the stroke volume (157.5 ± 47 ml) regurgitated into the left atrium. Ejection-fraction (67.7 ± 6%) was normal in all cases. Postoperative first pass technique was employed using a fast multicrystal camera (Baird Atomic, system 77). Volumes were assessed measuring normalized total count rate (count integral of the left ventricle divided by the maximum count density). 19.8 ± 11 months after valve replacement enddiastolic and endsystolic volumes revealed normal at rest (121.8 ± 38 resp. 52.8 ± 35 ml) and after maximum exercise (122.0 ± 29 resp. 37.6 ± 22 ml). Ejection fraction responded physiologically to exercise by rising from 57.7 ± 12 to 69.7 ± 10%.