Beyond that, the clinician must ask a series of questions to determine whether the patient is a good candidate for revascularization. Among the considerations are the patient's general health status, whether he or she will have adequate support at home during the recovery period, whether the patient has a history of angina, and the experience level of the surgeon and the hospital.
“These are not the kind of patients who should be operated on by low-volume operators in low-volume institutions,” he said.
He offered no strong recommendations on which specific imaging tests would be best, except to say that in practice clinicians should rely on the modality that has the greatest degree of reproducibility and accuracy in the local community.
Finally, he recommended counseling the patient and the family on the basis of widely available risk calculators.