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Rest and Exercise Myocardial Imaging in the Assessment of the Postoperative Cardiac Patient

  • Barry L. Zaret
Part of the Topics in Cardiovascular Disease book series (TCAD)

Abstract

An obvious application of the rest-and-exercise myocardial-imaging approach would be the study of patients having undergone aortocoronary bypass surgery. The recent introduction of this surgical modality has significantly altered the therapeutic approach toward patients with coronary heart disease. Coronary revascularization procedures are now being performed in patients representing the entire spectrum of coronary disease, ranging from the situation of minimally symptomatic angina pectoris to cardiogenic shock. However, postoperative subjective improvement may not, in all cases, be due to increased myocardial perfusion. Reduction or elimination of symptoms in the individual patient may also result from perioperative infarction of ischemic muscle, partial denervation, or placebo effect. On the other hand, symptoms may persist in the presence of entirely patent bypass grafts. Dispute currently rages as to whether the procedure, even in the face of symptomatic improvement, will have a long-term effect on patient survival and prognosis. Definitive objective evaluation of the postoperative patient has required cardiac catheterization and contrast angiography, which by their very nature are limited in terms of sequential study. For this reason, a noninvasive means of evaluating graft patency and myocardial viability would have definite clinical and investigative value. To this end, we have applied rest and exercise 43K and 81Rb myocardial imaging to the study of the postoperative patient.

Keywords

Myocardial Perfusion Postoperative Patient Angiographic Evaluation Transmural Infarction Coronary Revascularization Procedure 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. Zaret, B. L., Martin, N. D., McGowan, R. L., et al.,Rest and exercise potassium-43 myocardial perfusion imaging for the noninvasive evaluation of aortocoronary bypass surgery, Circulation 49:688 (1974).PubMedCrossRefGoogle Scholar
  2. Smith, R. O., Bennett, K. R., Suzuki, A., et al.,Atraumatic evaluation of myocardial revascularization procedures with 43K, Radiology 114:99 (1975).PubMedGoogle Scholar
  3. 3.
    Botti, R. E., and Maclntyre, W. J., Evaluation of surgical revascularization of the myocardium by peripheral 93K injection (abstract), Circulation 43: (Suppl IV): IV - 118 (1973).Google Scholar
  4. Zaret, B. L., Vlay, S., Freedman, G. S., et al.,Quantitative correlates of resting potassium-43 perfusion following myocardial infarction in man (abstract), Circulation 50,(Suppl III): III-4 (1974).Google Scholar

Copyright information

© Springer Science+Business Media New York 1977

Authors and Affiliations

  • Barry L. Zaret
    • 1
  1. 1.Departments of Internal Medicine and Diagnostic RadiologyYale University School of MedicineNew HavenUSA

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