Abstract
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.
Full text
PDF







Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Bailey I. K., Griffith L. S., Rouleau J., Strauss W., Pitt B. Thallium-201 myocardial perfusion imaging at rest and during exercise. Comparative sensitivity to electrocardiography in coronary artery disease. Circulation. 1977 Jan;55(1):79–87. doi: 10.1161/01.cir.55.1.79. [DOI] [PubMed] [Google Scholar]
- Barry W. H., Pfeifer J. F., Lipton M. J., Tilkian A. R., Hultgren H. N. Effects of coronary artery bypass grafting on resting and exercise hemodynamics in patients with stable angina pectoris: a prospective, randomized study. Am J Cardiol. 1976 May;37(6):823–830. doi: 10.1016/0002-9149(76)90105-3. [DOI] [PubMed] [Google Scholar]
- Bartel A. G., Behar V. S., Peter R. H., Orgain E. S., Kong Y. Exercise stress testing in evaluation of aortocoronary bypass surgery. Report of 123 patients. Circulation. 1973 Jul;48(1):141–148. doi: 10.1161/01.cir.48.1.141. [DOI] [PubMed] [Google Scholar]
- Benchimol A., dos Santos A., Desser K. B. Relief of angina pectoris in patients with occluded coronary bypass grafts. Am J Med. 1976 Mar;60(3):339–343. doi: 10.1016/0002-9343(76)90749-x. [DOI] [PubMed] [Google Scholar]
- Botvinick E. H., Taradash M. R., Shames D. M., Parmley W. W. Thallium-20 1 myocardial perfusion scintigraphy for the clinical clarification of normal, abnormal and equivocal electrocardiographic stress tests. Am J Cardiol. 1978 Jan;41(1):43–51. doi: 10.1016/0002-9149(78)90130-3. [DOI] [PubMed] [Google Scholar]
- Bulkely B. H., Hutchins G. M. Myocardial consequences of coronary artery bypass graft surgery. The paradox of necrosis in areas of revascularization. Circulation. 1977 Dec;56(6):906–913. doi: 10.1161/01.cir.56.6.906. [DOI] [PubMed] [Google Scholar]
- Chatterjee K., Swan H. J., Parmley W. W., Sustaita H., Marcus H. S., Matloff J. Influence of direct myocardial revascularization on left ventricular asynergy and function in patients with coronary heart disease. With and without previous myocardial infarction. Circulation. 1973 Feb;47(2):276–286. doi: 10.1161/01.cir.47.2.276. [DOI] [PubMed] [Google Scholar]
- Di Luzio V., Roy P. R., Sowton E. Angina in patients with occluded aorto-coronary vein grafts. Br Heart J. 1974 Feb;36(2):139–147. doi: 10.1136/hrt.36.2.139. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Dunkman W. B., Perloff J. K., Kastor J. A., Shelburne J. C. Medical perspectives in coronary artery surgery--a caveat. Ann Intern Med. 1974 Dec;81(6):817–837. doi: 10.7326/0003-4819-81-6-817. [DOI] [PubMed] [Google Scholar]
- Hammermeister K. E., Kennedy J. W., Hamilton G. W., Stewart D. K., Gould K. L., Lipscomb K., Murray J. A. Aortocoronary saphenous-vein bypass. Failure of successful grafting to improve resting left ventricular function in chronic angina. N Engl J Med. 1974 Jan 24;290(4):186–192. doi: 10.1056/NEJM197401242900403. [DOI] [PubMed] [Google Scholar]
- Klausner S. C., Botvinick E. H., Shames D., Ullyot D. J., Fishman N. H., Roe B. B., Ebert P. A., Chatterjee K., Parmley W. W. The application of radionuclide infarct scintigraphy to diagnose perioperative myocardial infarction following revascularization. Circulation. 1977 Aug;56(2):173–181. doi: 10.1161/01.cir.56.2.173. [DOI] [PubMed] [Google Scholar]
- Knoebel S. B., McHenry P. L., Phillips J. F., Lowe D. K. The effect of aortocoronary bypass grafts on myocardial blood flow reserve and treadmill exercise tolerance. Circulation. 1974 Oct;50(4):685–693. doi: 10.1161/01.cir.50.4.685. [DOI] [PubMed] [Google Scholar]
- Korbuly D. E., Formanek A., Gypser G., Moore R., Ovitt T. W., Tuna N., Amplatz K. Regional myocardial blood flow measurements before and after coronary bypass surgery. A preliminary report. Circulation. 1975 Jul;52(1):38–45. doi: 10.1161/01.cir.52.1.38. [DOI] [PubMed] [Google Scholar]
- Kreulen T. H., Kirk E. S., Gorlin R., Cohn L. H., Collins J. J., Jr Coronary artery bypass surgery: assessment of revascularization by determination of blood flow and myocardial mass. Am J Cardiol. 1974 Aug;34(2):129–135. doi: 10.1016/0002-9149(74)90190-8. [DOI] [PubMed] [Google Scholar]
- Lapin E. S., Murray J. A., Bruce R. A., Winterscheid L. Changes in maximal exercise performance in the evaluation of saphenous vein bypass surgery. Circulation. 1973 Jun;47(6):1164–1173. doi: 10.1161/01.cir.47.6.1164. [DOI] [PubMed] [Google Scholar]
- Lenaers A., Block P., Thiel E. V., Lebedellr M., Becquevort P., Erbsmann F., Ermans A. Segmental analysis of Ti-201 stress myocardial scintigraphy. J Nucl Med. 1977 Jun;18(6):509–516. [PubMed] [Google Scholar]
- McLaughlin P. R., Martin R. P., Doherty P., Daspit S., Goris M., Haskell W., Lewis S., Kriss J. P., Harrison D. C. Reproducibility of thallium-201 myocardial imaging. Circulation. 1977 Mar;55(3):497–503. doi: 10.1161/01.cir.55.3.497. [DOI] [PubMed] [Google Scholar]
- Mnayer M., Chahine R. A., Raizner A. E. Mechanisms of angina relief in patients after coronary artery bypass surgery. Br Heart J. 1977 Jun;39(6):605–609. doi: 10.1136/hrt.39.6.605. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Mundth E. D., Gerald Austen W. Surgical measures for coronary heart disease (second of three parts). N Engl J Med. 1975 Jul 10;293(2):75–80. doi: 10.1056/NEJM197507102930205. [DOI] [PubMed] [Google Scholar]
- Ritchie J. L., Narahara K. A., Trobaugh G. B., Williams D. L., Hamilton G. W. Thallium-201 myocardial imaging before and after coronary revascularization: assessment of regional myocardial blood flow and graft patency. Circulation. 1977 Nov;56(5):830–836. doi: 10.1161/01.cir.56.5.830. [DOI] [PubMed] [Google Scholar]
- Ritchie J. L., Trobaugh G. B., Hamilton G. W., Gould K. L., Narahara K. A., Murray J. A., Williams D. L. Myocardial imaging with thallium-201 at rest and during exercise. Comparison with coronary arteriography and resting and stress electrocardiography. Circulation. 1977 Jul;56(1):66–71. doi: 10.1161/01.cir.56.1.66. [DOI] [PubMed] [Google Scholar]
- Shepherd R. L., Itscoitz S. B., Glancy D. L., Stinson E. B., Reis R. L., Olinger G. N., Clark C. E., Epstein S. E. Deterioration of myocardial function following aorto-coronary bypass operation. Circulation. 1974 Mar;49(3):467–475. doi: 10.1161/01.cir.49.3.467. [DOI] [PubMed] [Google Scholar]
- Strauss H. W., Harrison K., Langan J. K., Lebowitz E., Pitt B. Thallium-201 for myocardial imaging. Relation of thallium-201 to regional myocardial perfusion. Circulation. 1975 Apr;51(4):641–645. doi: 10.1161/01.cir.51.4.641. [DOI] [PubMed] [Google Scholar]
- Zaret B. L., Martin N. D., McGowan R. L., Strauss H. W., Wells H. P., Jr, Flamm M. D., Jr Rest and exercise potassium-43 myocardial perfusion imaging for the noninvasive evaluation of aortocoronary bypass surgery. Circulation. 1974 Apr;49(4):688–695. doi: 10.1161/01.cir.49.4.688. [DOI] [PubMed] [Google Scholar]
