Dobutamine pharmacologic stress test coupled with dual isotope-stress hexakis 2-methoxy-isobutyl-isonitrile (MIBI), rest Thallium 201-perfusion SPECT was performed to a patient with an end-stage coronary artery disease who has physical limitations and cannot achieve a desired stress level with conventional stress protocols. Although this patient was assessed to be an inoperable case according to coronary angiography or echocardiography data, he was operated on the basis of imaging of a viable myocardium and reversible coronary ischemia to a significant extent in the dobutamine stress coupled with dual isotope study. The objective benefits of the operation was also shown on the postoperative data. We'd like to discuss an alternative diagnostic option contributing more appropriate solutions for patients with an end-stage coronary artery disease.
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