To determine the utility of thallium-201 stress scintigraphy in assessing the results of coronary bypass surgery, chest paln, stress electrocardiograms and sclntigrams were evaluated in 27 patients postoperatlvely. These findings were compared with coronary angiographie data in which a significant postoperative lesion was defined as 75 percent or more stenosis in a graft, its distal vessel or in an ungrafted native vessel. As an indicator of postoperative coronary lesions, chest pain lacked sensitivity (60 percent) and was nonspecific (20 percent). The stress electrocardiogram had poor sensitivity (60 percent) and good specificity (86 percent) but was not helpful in six patients who had equivocal or suboptimal tests. The scintigram had good sensitivity (77 percent) and was highly specific for the diagnosis of coronary stenosis. It was significantly more specific than chest pain ( P

Thallium-201 myocardial perfusion scintigraphy to evaluate patients after coronary bypass surgery.

The pacing stress test reexamined: Correlation of pacing-induced hemodynamic changes with the amount of myocardium at risk

Thirty-six patients were assessed by thallium-201 myocardial imaging before and after aortocoronary bypass operations and the results were compared with evaluation based on symptomatic assessment, exercise testing, and electrocardiography. After operation, the majority of patients were free from symptoms or symptomatically improved with increased exercise duration. Perioperative myocardial damage was shown in eight patients and myocardial ischaemia in 15 patients when assessed by thallium imaging during exercise. Thallium imaging proved more sensitive than electrocardiography in the demonstration of perioperative infarction and in the detection of postoperative ischaemia. Exercise electrocardiography may be misleading after aortocoronary bypass operations. Thallium imaging offers a simple, objective evaluation of the results of revascularisation procedures, throws light on the mechanisms of relief of angina by operation, and helps in the assessment of the patient whose progress is unsatisfactory after operation.

https://heart.bmj.com/content/heartjnl/42/4/455.full.pdf

Thallium-201 myocardial imaging in assessment of results of aortocoronary bypass surgery.

To determine the utility of thallium-201 stress scintigraphy for the assessment of coronary bypass surgery, we evaluated chest pain, stress electrocardiograms, and scintigrams in 27 patients following surgery. These findings were compared with those of coronary angiography where >7 5% stenosis in a graft, its distal vessel, or in an ungrafted native vessel, represented significant postoperative lesions. Chest pain lacked sensitivity (60%) and was nonspecific (20%) for the identification of postoperative coronary lesions. Stress electrocardiography had low sensitivity (60%) and good specificity (86%) for the diagnosis of coronary lesions. However, electrocardiography was not helpful in six patients who had equivocal or suboptimal tests. The scintigram had good sensitivity (77%) and was highly specific for the diagnosis of coronary stenosis. The scintigram was significantly more specific than chest pain (P <0.01), gave excellent localizing information, and added to the accuracy of both conclusive and inconclusive stress tests. In nine patients in whom preoperative stress scintigrams had also been obtained, comparison of pre- and postoperative studies reflected the effects of bypass surgery on coronary perfusion. Scintigraphy is a useful technique for the noninvasive evaluation of the postcoronary bypass patient and postoperative scintigraphy alone is of great value in documenting surgical results.

Thallium 201 Myocardial Perfusion Scintigraphy for the Evaluation of Post Coronary Bypass Patients

Ventricular unloading in the management of heart disease: role of vasodilators. Part I.

The physiologic assessment of critical coronary stenosis by relative myocardial perfusion imaging with atrial pacing

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The physiologic assessment of critical coronary stenosis by relative myocardial perfusion imaging with atrial pacing