Document Detail

Preoperative management of the patient with coronary artery disease before abdominal aortic surgery.
MedLine Citation:
PMID:  3496947     Owner:  NLM     Status:  MEDLINE    
Coronary artery disease accounts for more than half of the morbidity and mortality associated with abdominal aortic surgery. To improve the results of vascular surgery, the risk of perioperative cardiac ischemia should be evaluated in each patient. Routine coronary angiography demonstrated severe correctable coronary artery disease in 14% of patients who had no history or electrocardiographic evidence of coronary artery disease. Exercise testing before abdominal aortic aneurysm repair will identify patients at high risk of cardiac ischemia. Dipyridamole-thallium imaging will identify high-risk patients before surgery for aortoiliac occlusive disease. Some patients with symptomatic coronary disease who are at extremely high risk should undergo preoperative coronary revascularization. Others should have their vascular surgery deferred, because their cardiac risk may exceed the anticipated benefit of the vascular surgery. Patients at moderate risk may need more intensive intraoperative monitoring. Patients without evidence of cardiac ischemia with stress may undergo vascular surgery with a low risk of perioperative cardiac ischemia. Finally, patients who have evidence of ischemic heart disease should be considered for coronary revascularization following successful vascular repair in order to prolong their survival.
R D Weisel
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Canadian journal of surgery. Journal canadien de chirurgie     Volume:  30     ISSN:  0008-428X     ISO Abbreviation:  Can J Surg     Publication Date:  1987 Jul 
Date Detail:
Created Date:  1987-09-02     Completed Date:  1987-09-02     Revised Date:  2007-08-16    
Medline Journal Info:
Nlm Unique ID:  0372715     Medline TA:  Can J Surg     Country:  CANADA    
Other Details:
Languages:  eng     Pagination:  237-9     Citation Subset:  IM    
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MeSH Terms
Aorta, Abdominal / surgery
Aortic Aneurysm / surgery
Aortic Diseases / surgery*
Coronary Artery Bypass
Coronary Disease / diagnosis*,  radiography,  surgery
Exercise Test
Preoperative Care*

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

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