Summary of conference

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It will be difficult for me to close this Symposium analyzing in such a short period the basic material presented during the 3 days. I think that the subject of myocardial revascularization has been discussed in depth, a noteworthy amount of data have been accumulated, and several conclusions have been reached. I will only present some ideas which I think are important for the future.

Diagnostic procedures

The diagnosis of coronary insufficiency or ischemic myocardiopathy is based on a carefully elicited clinical history. Other noninvasive techniques constitute a tremendous advance in the diagnosis and prognosis of patients with coronary arteriosclerosis. Ergometric tests are a clear example; not only do they confirm or exclude a diagnosis, but help categorize patients as regards their physical capacity, mainly patients with stable angina. By means of ergometric tests high risk patients in need of further investigation are properly identified.

Cross sectional echocardiography and radioisotopes (technetium 99m stannous pyrophosphate and thallium 201) are precise tools to analyze and tabulate the implications of diminished coronary flow at the muscular level. I believe that the use of echocardiography and radioisotopes will be justified in patients with acute coronary insufficiency, impending infarction, and acute myocardial infarction to differentiate contraction abnormalities due to anoxia or necrosis. These two methods will enable us to extend our present surgical indications.

Notwithstanding these late advances, selective cine coronary angiography remains the cornerstone as far as diagnostic procedures are concerned. It has helped us to visualize more precisely the anatomy of the coronary . . .



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