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.
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