Document Detail

Validation of an updated approach to preoperative cardiac risk assessment in vascular surgery.
MedLine Citation:
PMID:  14627248     Owner:  NLM     Status:  MEDLINE    
To validate a more selective approach to cardiac assessment which consisted of limiting stress testing and coronary revascularization to highly selected patients and limiting coronary revascularization to patients with severe cardiac symptoms, we compared two time periods (1994-1995 and 2000-2001) with respect to cardiac work-up and cardiac morbidity and mortality. Our method involved a retrospective review of patients undergoing vascular procedures from 2000 to 2001 at a single institution. In group 1 (2000-2001), 139 operations were performed on 120 patients. In group 2 (1994-1995), 145 procedures were performed on 109 patients. Preoperative stress testing was reduced from 42 patients (29%) in group 2 to 20 patients (14%) in group 1 (P < 0.01), and preoperative coronary artery bypass grafting was reduced from six (4.1%) to two (1.4%) (P < 0.28), respectively. Coronary angiography was unchanged: 8 (5.8%) patients in group 1 versus 11 (7.9%) patients in group 2 (P = NS). Two (1.4%) patients underwent percutaneous transluminal coronary angioplasty in group 1 and group 2. Cardiac event rates were similar: seven (5%) patients in both groups. Cardiac death was not significantly different: two (1.4%) in group 1 versus one (0.7%) in group 2. Cardiac morbidity and mortality after major vascular surgery remain the same despite using a more selective cardiac stress protocol.
Hao Bui; Jason T Lee; Scott Greenway; Carlos Donayre; Christian de Virgilio
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Publication Detail:
Type:  Journal Article; Validation Studies    
Journal Detail:
Title:  The American surgeon     Volume:  69     ISSN:  0003-1348     ISO Abbreviation:  Am Surg     Publication Date:  2003 Nov 
Date Detail:
Created Date:  2003-11-20     Completed Date:  2003-12-23     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370522     Medline TA:  Am Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  923-6     Citation Subset:  IM    
Department of Surgery, Division of Vascular Surgery, Harbor-UCLA Medical Center, Torrance, California 90509, USA.
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MeSH Terms
Coronary Angiography
Coronary Artery Bypass / mortality
Coronary Disease / diagnosis,  mortality
Dipyridamole / diagnostic use
Dobutamine / diagnostic use
Echocardiography, Stress
Heart Function Tests*
Myocardial Infarction / diagnosis,  etiology
Postoperative Complications
Preoperative Care*
Retrospective Studies
Risk Factors
Survival Rate
Vascular Surgical Procedures*
Reg. No./Substance:
34368-04-2/Dobutamine; 58-32-2/Dipyridamole

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

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