Document Detail


Screening of patients with ischemic heart disease by transesophageal atrial pacing and the selection of surgical therapy: in patients with arteriosclerosis obliterans and aortic aneurysm.
MedLine Citation:
PMID:  7721927     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study evaluated (1) a screening method for ischemic heart disease (IHD) using transesophageal atrial pacing (TEP), and (2) the appropriate surgical therapy for patients with concomitant IHD which was evaluated on the basis of the coronary score (CS) by Leaman. Thirty-nine patients with arteriosclerosis obliterans of the lower extremities (ASO) and 35 with aortic aneurysm underwent TEP and coronary angiography (CAG). Coexistent IHD was diagnosed in 25 patients (64%) with ASO and in 14 (40%) with aortic aneurysm. Screening for IHD by TEP was 96% sensitive, 71% specific, and 87% accurate in patients with ASO, and 79% sensitive, 90% specific, and 86% accurate in patients with aortic aneurysm. Coronary artery bypass grafting (CABG) and peripheral arterial revascularization (PAR) were performed by one stage surgery in 3 patients with a CS of 16 or more. In 18 patients with a CS of 5.5 or less, only PAR was performed. One stage surgery was performed in 6 patients with aortic aneurysm. Four patients had a CS of 9.5 or more, and 2 patients with coexistent stenosis of the left anterior descending branch (LAD) had CS of 3.5 and 8, respectively. Repair of the aneurysm was undertaken in 5 patients with a CS of 8 or less without LAD disease. In patients with ASO showing a CS of 5.5 or less and in those with aortic aneurysm showing a CS of 8 or less (and without LAD disease), the only surgical procedure performed was either PAR or repair of the aneurysm. There were no complications attributable to IHD observed in these patients during the perioperative period.
Authors:
K Azuma; H Hirose; K Matsumoto; S Fuwa; Y Mori; S Murakawa; H Arakawa; M Ishikawa
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Journal of cardiovascular surgery     Volume:  36     ISSN:  0021-9509     ISO Abbreviation:  J Cardiovasc Surg (Torino)     Publication Date:  1995 Feb 
Date Detail:
Created Date:  1995-05-25     Completed Date:  1995-05-25     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0066127     Medline TA:  J Cardiovasc Surg (Torino)     Country:  ITALY    
Other Details:
Languages:  eng     Pagination:  61-9     Citation Subset:  IM    
Affiliation:
First Department of Surgery, Gifu University, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Angina Pectoris / diagnosis,  physiopathology
Aortic Aneurysm, Abdominal / complications,  diagnosis*,  surgery
Aortic Aneurysm, Thoracic / complications,  diagnosis*,  surgery
Arteriosclerosis Obliterans / complications,  diagnosis*,  surgery
Cardiac Pacing, Artificial / methods*
Coronary Angiography
Esophagus
Female
Heart Atria / physiopathology
Humans
Leg / blood supply*
Male
Middle Aged
Myocardial Ischemia / diagnosis*,  physiopathology
Sensitivity and Specificity

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


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