Improved selection of patients for aneurysmectomy by combined phase and amplitude analysis of gated cardiac scintigraphy.

Twelve patients undergoing left ventricular aneurysmectomy were studied by combined phase and amplitude analysis of gated blood pool scintigraphy before and after operation, to establish whether the presence of paradoxical systolic movement, as defined by this method, influenced the result of surgical treatment. There was a significant increase in the ejection fraction after operation in those patients with paradoxical systolic movement and no improvement in those with akinesis. The extent of the increase in ejection fraction was related to the size of paradoxical segment resected. It is argued that this improvement in left ventricular function reflects a reduction in the left ventricular and diastolic volume and improved efficiency of ejection of the stroke volume, resulting from resection of the scar. Combined phase and amplitude analysis may help in selecting patients most likely to benefit from aneurysmectomy.