THE UTILITY OF DOBUTAMINE ECHOCARDIOGRAPHY IN PREOPERATIVE EVALUATIONFOR ELECTIVE AORTIC-SURGERY

BACKGROUND: Preoperative cardiac evaluations have been advocated prior to major vascular procedures to reduce the incidence of postoperative cardiac complications. This study was undertaken to evaluate the effi cacy and predictive value of routine dobutamine echocardiography (DE) in the screening of patients undergoing elective aortic surgery. METHO DS: Dobutamine echocardiography was performed preoperatively on all pa tients having elective aortic procedures by our university surgical gr oup from June 1995 to August 1996. The cardiac morbidity and mortality from this group were compared with that of a similar group undergoing elective aortic procedures from June 1993 to May 1995 with no dobutam ine echocardiography (NDE). RESULTS: Although there was no statistical ly significant difference in either overall mortality (4.4% in NDE vs. 2.3% in DE) or cardiac mortality (2.9% in NDE vs. 0% in DE) between t he two groups, cardiac events occurred only in those patients with pre vious coronary artery disease. In addition, dobutamine echocardiograph y had a negative predictive value of 97% CONCLUSIONS: Although routine screening is not necessary, selective screening of patients using dob utamine stress echocardiography is justified because of its high negat ive predictive value. (C) 1997 by Excerpta Medica Inc.