Use of Myocardial Perfusion SPECT for Preoperative Risk Stratification of Non-Cardiac Surgery

It is difficult to assess the likelihood of perioperative cardiac events mainly because of complicated interrelationships between clinical risk and type of surgery. To overcome this problem, The American College of Cardiology/American Heart Association(ACC/AHA)Task Force published guidelines for perioperative cardiovascular evaluation for non-cardiac surgery. The guidelines offer the strategy of preoperative cardiac therapy, operative performance and perioperative management depending on the urgency of surgery, the patient$s risk factors, findings of cardiac testing and specific surgical considerations. Non-invasive cardiac testing including myocardial perfusion single-photon emission computed tomography(SPECT)is recommended to be used mainly in patients with poor functional capacity, when the results will affect patient treatment and outcomes. In the current review, we summarized the use of stress myocardial perfusion SPECT referring to previous reports and our data, and provided the tips for indication of SPECT in preoperative risk stratification in non-cardiac surgery.