Document Detail


Low ejection fraction predicts shortened survival in patients undergoing infrainguinal arterial reconstruction.
MedLine Citation:
PMID:  17952496     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: With the advent of endovascular therapy for lower extremity ischemia it is important to better determine what factors may affect the outcome. The goal of the present study was to evaluate whether ejection fraction (EF) is predictive of outcome in infrainguinal arterial reconstruction. METHODS: We retrospectively reviewed 736 patients undergoing 897 infrainguinal arterial reconstructions from July 1999 to February 2002. Patients were divided into two groups: group I contained 54 patients with an EF<35% and group II had 216 patients with an EF > or =35%. The outcome evaluated was major adverse clinical events (MACEs), defined as postoperative myocardial infarction (MI), arrhythmia, congestive heart failure (CHF), and perioperative mortality. RESULTS: Major adverse clinical events occurred in 20.3% of patients (11/54) in group I and 10.6% patients (23/216) in group II (p = 0.068). Group I had a trend toward a greater incidence of MACEs compared to group II. Two-year survival for group I was 61.7%, whereas survival for group II was 78.4% (p = 0.0085). CONCLUSIONS: Low EF predicts a significantly shortened 2-year survival after infrainguinal arterial reconstruction and a trend toward increased perioperative complications. This is another factor to be considered in choosing open versus endovascular options.
Authors:
Gautam V Shrikhande; Allen D Hamdan; Thomas S Monahan; Frank B Pomposelli; Sherry D Scovell; Frank W Logerfo; Marc Schermerhorn
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  World journal of surgery     Volume:  31     ISSN:  0364-2313     ISO Abbreviation:  World J Surg     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-12-06     Completed Date:  2008-03-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2422-6     Citation Subset:  IM    
Affiliation:
Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA. gshrikha@caregroup.harvard.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Arteries / surgery*
Female
Humans
Intraoperative Complications
Kaplan-Meiers Estimate
Lower Extremity / blood supply*,  surgery*
Male
Middle Aged
Peripheral Vascular Diseases / surgery
Postoperative Complications
Retrospective Studies
Risk Factors
Stroke Volume*
Vascular Surgical Procedures / contraindications*,  statistics & numerical data

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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