Document Detail


Routine preoperative carotid duplex scanning in patients undergoing open heart surgery: is it worthwhile?
MedLine Citation:
PMID:  11769149     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
It has been reported that carotid screening may be cost-effective in patient populations in which the prevalence of severe carotid stenosis exceeds 4.5%. In order to identify potential patient populations who might benefit from carotid screening, we examined the results of preoperative duplex scanning in patients undergoing open heart surgery. Between January 1995 and July 1998, 3708 patients (59% male, 41% female) underwent open heart surgery at our institution. Of these, 3081 underwent coronary artery bypass grafting (CABG), 364 underwent valve replacement (VR), and 263 underwent CABG and VR. The ages of these patients ranged from 40 years to 98 years (mean 68 +/- 11 years). The risk factors analyzed included hypertension (HTN), 59%; smoking (Smk), 53%; and diabetes (DM), 33%. Patients were divided into three groups according to their age. Group A consisted of the 835 patients who were < or = 60 years old, group B consisted of 2474 patients ranging from 61 years to 80 years old, and group C consisted of 399 patients who were > or = 81 years old. All patients underwent bilateral preoperative carotid duplex scans at an Intersocietal Commission for the Accreditation of Vascular Laboratories (ICAVL)-accredited vascular laboratory. Statistical analyses were performed using chi-squared, Fisher's exact test, linear regression, and multivariate analysis. From our results we concluded that carotid screening is not recommended for patients under 60 years of age who are undergoing CABG unless they present with a minimum of two of the following major risk factors: hypertension, diabetes, or smoking. However, carotid screening is recommended for all patients undergoing open heart operations who are over the age of 60 years old, regardless of the absence of associated risk factors.
Authors:
E Ascher; A Hingorani; W Yorkovich; P J Ramsey; S Salles-Cunha
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Publication Detail:
Type:  Comparative Study; Journal Article; Review    
Journal Detail:
Title:  Annals of vascular surgery     Volume:  15     ISSN:  0890-5096     ISO Abbreviation:  Ann Vasc Surg     Publication Date:  2001 Nov 
Date Detail:
Created Date:  2001-12-21     Completed Date:  2002-07-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8703941     Medline TA:  Ann Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  669-78     Citation Subset:  IM    
Affiliation:
Division of Vascular Surgery, Maimonides Medical Center, 4802 Tenth Avenue, Brooklyn, N York 11219, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Aged
Aged, 80 and over
Cardiac Surgical Procedures*
Carotid Artery, Common / ultrasonography*
Carotid Stenosis / diagnosis*,  mortality,  surgery*
Coronary Artery Bypass / mortality
Diagnostic Tests, Routine*
Female
Heart Valve Prosthesis Implantation / mortality
Humans
Incidence
Logistic Models
Male
Middle Aged
New York / epidemiology
Predictive Value of Tests
Preoperative Care*
Prevalence
Risk Factors
Severity of Illness Index
Sex Factors
Smoking
Survival Analysis
Treatment Outcome
Ultrasonography, Doppler, Duplex*

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


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