Document Detail

Operative and nonoperative risks in the cardiac patient.
MedLine Citation:
PMID:  1206186     Owner:  NLM     Status:  MEDLINE    
Four hundred and sixteen patients with documented arteriosclerotic heart disease (ASHD) underwent 424 diagnostic and therapeutic surgical procedures during the year 1970 at the Henry Ford Hospital. They were classified according to the specific clinical manifestation of their cardiac abnormality. Patients with a history of old, well-compensated myocardial infarction, and those with cardiac arrhythmia, bundle-branch block, congestive heart failure and A-V block (pacemaker-protected) but no evidence of previous myocardial infarction fared almost as well as subjects of the same age without cardiac disease, and were considered to run the lowest operative risk. Patients with angina, especially if there was a history of infarction, were an intermediate risk in terms of complications and mortality. Patients with a history of previous infarction complicated at the time of the surgical procedure by arrhythmia, A-V block, bundle-branch block, or congestive heart failure were in the "highest risk" category. A severe A-V block indicated the need for insertion of a "prophylactic" pacemaker before any attempt at a diagnostic or therapeutic procedure. No patient with clinical or electrocardiographic evidence of a recent infarction (less than three months' duration) should undergo any elective surgical procedure under any form of anesthesia unless the surgeon is prepared for a high mortality rate that may approach 90 percent. In contrast, the patient with old, well-compensated myocardial infarction and no evidence of dysrhythmia, block or congestive failure can tolerate even a major surgical operation under any form of anesthesia extremely well.
J A Sapala; J L Ponka; W F Duvernoy
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American Geriatrics Society     Volume:  23     ISSN:  0002-8614     ISO Abbreviation:  J Am Geriatr Soc     Publication Date:  1975 Dec 
Date Detail:
Created Date:  1976-03-18     Completed Date:  1976-03-18     Revised Date:  2008-03-10    
Medline Journal Info:
Nlm Unique ID:  7503062     Medline TA:  J Am Geriatr Soc     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  529-34     Citation Subset:  IM    
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MeSH Terms
Anesthesia / adverse effects
Cardiovascular Diseases / complications
Coronary Disease / complications,  mortality*,  surgery
Heart Block / therapy
Middle Aged
Pacemaker, Artificial
Postoperative Complications / prevention & control
Surgical Procedures, Operative / adverse effects*

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