Document Detail


Prophylactic myocardial revascularization based on dipyridamole-thallium scanning before peripheral vascular surgery.
MedLine Citation:
PMID:  8076096     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
J B Steinberg; T F Kresowik; D M Behrendt
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Cardiovascular surgery (London, England)     Volume:  1     ISSN:  0967-2109     ISO Abbreviation:  Cardiovasc Surg     Publication Date:  1993 Oct 
Date Detail:
Created Date:  1994-10-06     Completed Date:  1994-10-06     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9308765     Medline TA:  Cardiovasc Surg     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  552-7     Citation Subset:  IM    
Affiliation:
Division of Cardiothoracic Surgery, University of Iowa Hospitals and Clinics, Iowa City 52242.
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MeSH Terms
Descriptor/Qualifier:
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:
0/Thallium Radioisotopes; 58-32-2/Dipyridamole

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


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