Advertisement

Objective Assessment of Cardiac Function in Vascular Surgery

  • Pierre Foëx
Part of the Developments in Critical Care Medicine and Anesthesiology book series (DCCA, volume 31)

Abstract

It is well recognized that patients undergoing peripheral vascular surgery are at risk for postoperative cardiac complications of anesthesia and surgery (1,2). This relates directly to the prevalence of coronary artery disease and/or hypertensive heart disease in such patients. However, as coronary artery disease may be asymptomatic, the preoperative assessment may fail to elicit symptoms or signs of coronary disease. Thus, postoperative complications may occur in patients in whom the absence of symptoms or signs of heart disease may have been falsely reassuring.

Keywords

Abdominal Aortic Aneurysm Cardiac Risk Noncardiac Surgery Myocardial Scintigraphy Hypertensive Heart Disease 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Diehl JT, Cali RF, Hertzer NR, Beven EG. Complications of abdominal aortic reconstruction. An analysis of perioperative risk factors in 557 patients. Ann Surg 197:49–56, 1983PubMedGoogle Scholar
  2. 2.
    Mackey WC, O’Donnell TF, Callow AD. Cardiac risk in patients undergoing carotid endarterectomy: impact on perioperative and long-term mortality. J Vase Surg 11:226–234, 1990Google Scholar
  3. 3.
    Goldman L, Caldera DL, Nussbaum SR, et al. Multifactorial index of cardiac risk in noncardiac surgical procedures. N Engl Med 297:845–850, 1977CrossRefGoogle Scholar
  4. 4.
    Detsky AS, Abrams HB, Forbath N, Scott JG, Hilliard JR. Cardiac assessment for patients undergoing non-cardiac surgery: a multifactorial clinical risk index. Arch Intern Med 146:2131–2134, 1986PubMedCrossRefGoogle Scholar
  5. 5.
    Larsen SF, Olesen E, Jacobsen H, et al. Prediction of cardiac risk in non-cardiac surgery. Eur Heart J 8:179–185, 1987PubMedGoogle Scholar
  6. 6.
    Jeffrey CC, Lunsman J, Cullen DJ, Brewster DC. A prospective evaluation of cardiac risk index. Anesthesiology 1983:58: 462–464. 1983Google Scholar
  7. 7.
    Goldman L. Multifactorial Index of cardiac risk in non-cardiac surgery. 10-year status report. J Cardiothor Anesth 1:237–244, 1987CrossRefGoogle Scholar
  8. 8.
    Wong T, Detsky AJ. Preoperative risk assessment for patients having peripheral vascular surgery. Ann Intern Med 116:743–753, 1992PubMedGoogle Scholar
  9. 9.
    Jivegard L, Frid I, Haljamae H, Hallenberg B, Holm J, Johansson SR. Cardiac risk and peripheral vascular surgery: new approach based on a multifactorial risk index. Br J Surg 80:354–358, 1993PubMedCrossRefGoogle Scholar
  10. 10.
    Sagel SS, Evens RG, Forrest JV, Bramson RT. Efficacy of routine screening and lateral chest radiographs in a hospital-based population. New Engl J Med 1974: 291:1001–1004, 1974PubMedCrossRefGoogle Scholar
  11. 11.
    Hoffmann R, Lethen H, Kleinhans E, Weiss M, Flachskampf FA, Hanrath P. Comparative evaluation of bicycle and dobutamine stress echocardiography with perfusion scintigraphy and bicycle electrocardiogram for identification of coronary artery disease. Am J Cardiol 72:555–559, 1993PubMedCrossRefGoogle Scholar
  12. 12.
    McPhail N, Calvin JE, Shariatmadar A, Barber GG, Scobie TK. The use of preoperative exercise testing to predict cardiac complications after arterial reconstruction. J Vase Surg 7:60–68, 1988Google Scholar
  13. 13.
    Raby KE, Barry J, Creager MA, Crook F, Weisberg MC, Goldman L. Detection and significance of intraoperative and postoperative myocardial ischemia in peripheral vascular surgery. JAMA 268: 222–227, 1992PubMedCrossRefGoogle Scholar
  14. 14.
    Raby KE, Goldman L, Creager MA, et al. Correlation between preoperative ischemia and major cardiac events after peripheral vascular surgery. N Engl J Med 321:1296–1300, 1989PubMedCrossRefGoogle Scholar
  15. 15.
    Ouyang P, Gerstenblith G, Furman WR, Golueke PJ, Gottlieb SO. Coronary artery disease: frequency and significance of early postoperative silent myocardial ischemia in patients having peripheral vascular surgery. Am J Cardiol 64:1113–1116, 1989PubMedCrossRefGoogle Scholar
  16. 16.
    Pasternack PF, Grossi EA, Baumann FG, et al. The value of silent ischemia monitoring in the prediction of perioperative myocardial infarction in patients undergoing peripheral vascular surgery. J Vase Surg 10:617–625, 1989Google Scholar
  17. 17.
    Mangano D, Browner W, Hollenberg M, London M, Tubau J, Tateo I. Association of perioperative myocardial ischaemia with cardiac morbidity and mortality in men undergoing noncardiac surgery. N Engl J Med 323:1781–1788, 1990PubMedCrossRefGoogle Scholar
  18. 18.
    Mangano DT, Browner WS, Hollenberg M, Tateo IM. Long-term cardiac prognosis following noncardiac surgery. JAMA 268:233–239, 1992PubMedCrossRefGoogle Scholar
  19. 19.
    Muir AD, Reeder MK, Foëx P, Ormerod OJM, Sear JW, Johnston C. Preoperative silent myocardial ischaemia: Incidence and predictors in a general surgical population. Br J Anaesth 67:373–377, 1991PubMedCrossRefGoogle Scholar
  20. 20.
    Hemming AE, Howell S, Sear JW, Foëx P. Admission blood pressure is predictive of silent myocardial ischaemia in treated hypertension. Br J Anaesth 1993, 71:760P, 1993Google Scholar
  21. 21.
    Allman KG, Muir A, Howell SJ, Hemming AE, Sear JW, Foëx P. Resistant hypertension and preoperative silent myocardial ischaemia in surgical patients. Br J Anaesth 73:574–578, 1994PubMedCrossRefGoogle Scholar
  22. 22.
    Folland ED, Parisi AF, Moynihan PF. Assessment of left ventricular ejection fraction and volumes by real-time, two-dimensional echocardiography. Circulation 60:760–766, 1979PubMedGoogle Scholar
  23. 23.
    Boucher CA, Brewster DC, Darling RC, Okada RD, Strauss HW, Pohost GM. Determination of cardiac risk by dipyridamole-thallium imaging before peripheral vascular surgery. N Engl J Med 312:389–394, 1985PubMedCrossRefGoogle Scholar
  24. 24.
    Leppo J, Plaja J, Gionet M, Tumolo J, Paraskos JA, Cutler BS. Noninvasive evaluation of cardiac risk before elective vascular surgery. J Am Coll Cardiol 9:269–276, 1987PubMedCrossRefGoogle Scholar
  25. 25.
    Lette J, Waters D, Lassonde J, et al. Multivariate clinical models and quantitative dipyridamole-thallium imaging to predict cardiac morbidity and death after vascular reconstruction. J Vasc Surg 14:160–169, 1991PubMedCrossRefGoogle Scholar
  26. 26.
    Baron JF, Mundler O, Bertrand M, et al. Dipyridamole-thallium scintigraphy and gated radionuclide angiography to assess cardiac risk before abdominal aortic surgery. N Engl J Med 330:663–669, 1994PubMedCrossRefGoogle Scholar
  27. 27.
    Dirksen JT, Kjoller E. Cardiac predictors of death after non-cardiac surgery evaluated by intention to treat. Lancet 297:1011–1013, 1988Google Scholar
  28. 28.
    Fiser WP, Thompson BW, Thompson AR, Eason C, Read RC. Nuclear cardiac ejection fraction and cardiac index in abdominal aortic surgery. Surgery 94:736–739, 1983PubMedGoogle Scholar
  29. 29.
    Fletcher JP, Antico VF, Grunwald S, Kershaw LZ. Prediction of cardiac risk in aortic surgery by gated heart pool scan. Br J Surg 76: 26–2, 1989PubMedCrossRefGoogle Scholar
  30. 30.
    Pasternack PF, Imparato AM, Bear G, et al. The value of radionuclide angiography as a predictor of perioperative myocardial infarction in patients undergoing abdominal aortic aneurysm resection. J Vasc Surg 1:320–325, 1984PubMedGoogle Scholar
  31. 31.
    Mc Cann RL, de Wolfe WG. Resection of abdominal aortic aneurysm in patients with low ejection fraction. J Vasc Surg 10:240–244, 1989Google Scholar
  32. 32.
    Mantha S, Roizen MF, Barnard J, Thisted RA, Ellis JE, Foss J. Relative effectiveness of four preoperative tests for predicting adverse cardiac outcome after vascular surgery: a meta-analysis. Anesth Analg 79:422–433, 1994PubMedCrossRefGoogle Scholar

Copyright information

© Kluwer Academic Publishers 1996

Authors and Affiliations

  • Pierre Foëx

There are no affiliations available

Personalised recommendations