Preoperative cardiac evaluation is unnecessary in most patients undergoingvascular operations

Citation
Kmf. Itani et al., Preoperative cardiac evaluation is unnecessary in most patients undergoingvascular operations, AM J SURG, 176(6), 1998, pp. 671-674
Citations number
22
Categorie Soggetti
Surgery,"Medical Research Diagnosis & Treatment
Journal title
AMERICAN JOURNAL OF SURGERY
ISSN journal
00029610 → ACNP
Volume
176
Issue
6
Year of publication
1998
Pages
671 - 674
Database
ISI
SICI code
0002-9610(199812)176:6<671:PCEIUI>2.0.ZU;2-6
Abstract
BACKGROUND: This study evaluated the impact of Goldman's index (GI), radion uclide ventriculography (RVG), and dipyridamole-thallium scintigraphy (DTS) on predicting cardiac outcome after vascular operations. METHODS: A total of 463 consecutive patients undergoing vascular operations were divided into those who had no DTS, those who had reversible ischemia by DTS, and those who had no reversible ischemia by DTS, GI, ejection fract ion, wall motion abnormalities, rate of coronary angiography, and revascula rization were determined for each group. RESULT: Coronary revascularization was ultimately performed in 8% of patien ts with no DTS, 7% of patients with no ischemia by DTS, and 9% of patients with ischemia by DTS, The GI of 6.1 in patients who died postoperatively wa s significantly higher than the GI of 3.6 in patients who survived (P = 0.0 2), RVG did not predict mortality, morbidity, or need for coronary revascul arization. CONCLUSION: Clinical assessment remains a good predictor for cardiac outcom e in patients undergoing vascular operations. More extensive cardiac testin g should be reserved for patients with higher GI and active cardiac problem s. Am J Surg. 1998;176:671-675, (C) 1998 by Excerpta Medica, Inc.