| Prophylactic myocardial revascularization based on dipyridamole-thallium scanning before peripheral vascular surgery. | |
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MedLine Citation:
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PMID: 8076096 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Cardiac events continue to be the leading cause of perioperative mortality following peripheral vascular reconstruction. The role of preoperative cardiac screening and prophylactic myocardial revascularization in patients without clinical evidence of coronary artery disease is undefined. Fifteen patients with no clinical evidence of coronary artery disease who were found to have reversible defects on dipyridamole-thallium scans and severe correctable coronary artery disease underwent aortocoronary artery bypass grafting. There was one (6.7%) operative death. Three patients (20%) developed postoperative complications: two atrial fibrillation and one breakdown of the saphenous vein harvest site. Thirteen patients underwent subsequent peripheral vascular surgery: seven had abdominal aortic procedures, three infrainguinal reconstruction, two carotid endarterectomy and one carotid-subclavian artery bypass. There were no perioperative or late deaths, cardiac complication, electrocardiographic changes, or episodes of angina associated with the peripheral vascular procedures. Thus, dipyridamole-thallium imaging appears to help select a group of symptom-free, but high cardiac risk, vascular patients in whom preparatory myocardial revascularization and subsequent peripheral vascular surgery can be performed with acceptable mortality and morbidity. The life expectancy of these patients may be improved and, specifically, the risk of their subsequent vascular surgery may be reduced by this approach. |
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Authors:
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J B Steinberg; T F Kresowik; D M Behrendt |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Cardiovascular surgery (London, England) Volume: 1 ISSN: 0967-2109 ISO Abbreviation: Cardiovasc Surg Publication Date: 1993 Oct |
Date Detail:
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Created Date: 1994-10-06 Completed Date: 1994-10-06 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 9308765 Medline TA: Cardiovasc Surg Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 552-7 Citation Subset: IM |
Affiliation:
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Division of Cardiothoracic Surgery, University of Iowa Hospitals and Clinics, Iowa City 52242. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Arterial Occlusive Diseases / mortality, surgery* Cause of Death Combined Modality Therapy Coronary Artery Bypass* Coronary Disease / mortality, radionuclide imaging*, surgery Dipyridamole / diagnostic use* Female Humans Male Middle Aged Myocardial Infarction / mortality, prevention & control*, radionuclide imaging Postoperative Complications / mortality, prevention & control*, radionuclide imaging Preoperative Care Risk Factors Thallium Radioisotopes / diagnostic use* |
| Chemical | |
Reg. No./Substance:
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0/Thallium Radioisotopes; 58-32-2/Dipyridamole |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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