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Titolo:
DOBUTAMINE STRESS ECHOCARDIOGRAPHY FOR CARDIAC RISK ASSESSMENT BEFOREAORTIC-SURGERY
Autore:
LANGAN EM; YOUKEY JR; FRANKLIN DP; ELMORE JR; COSTELLO JM; NASSEF LA;
Indirizzi:
GEISINGER MED CLIN,VASC SURG CLIN DANVILLE PA 17822 GEISINGER MED CLIN,VASC SURG CLIN DANVILLE PA 17822 GEISINGER MED CLIN,DEPT CARDIOL DANVILLE PA 17822
Titolo Testata:
Journal of vascular surgery
fascicolo: 6, volume: 18, anno: 1993,
pagine: 905 - 913
SICI:
0741-5214(1993)18:6<905:DSEFCR>2.0.ZU;2-K
Fonte:
ISI
Lingua:
ENG
Soggetto:
CORONARY-ARTERY DISEASE; PERIPHERAL VASCULAR-DISEASE; SCREENING-TEST; MANAGEMENT; COMPLICATIONS; ANEURYSMS; RECONSTRUCTION; SCINTIGRAPHY; EVENTS; BYPASS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
35
Recensione:
Indirizzi per estratti:
Citazione:
E.M. Langan et al., "DOBUTAMINE STRESS ECHOCARDIOGRAPHY FOR CARDIAC RISK ASSESSMENT BEFOREAORTIC-SURGERY", Journal of vascular surgery, 18(6), 1993, pp. 905-913

Abstract

Purpose: This study evaluates dobutamine stress echocardiography (DSE) for perioperative cardiac risk assessment with elective aortic surgery. Methods: Dobutamine stress echocardiography was used to evaluate 81 patients before infrarenal aortic surgery. Patients were placed intothree groups. Group I (n = 31) had normal DSEs. Group II (n = 25) hadresting wall motion abnormalities without dobutamine-induced changes of ischemia. Group III (n = 25) had evidence of dobutamine-induced ischemia. Patient analysis revealed that of 46 patients with clinical indicators of coronary artery disease (CAD), only 23 had DSEs with inducible ischemia. Two of 35 patients without clinical indicators of CAD had DSEs with inducible ischemia. Results: The 56 patients in groups I and II underwent aortic reconstruction without cardiac complications ordeath. Of the 25 patients in group III, surgery was deferred in five (two patients with claudication and three with aneurysms less than or equal to 5 cm), and four underwent coronary artery bypass grafting. Outcome after coronary artery bypass grafting included one death from stroke, one aneurysm rupture, and two uncomplicated aortic reconstructions. The remaining 16 patients in group III underwent aortic surgery, with three postoperative myocardial infarctions (MI) and no deaths. Conclusions: Using DSE for preoperative assessment of cardiac risk allowed us to operate on 74 of 81 patients being considered for elective aortic reconstruction, with no operative deaths and a 4.1% rate of perioperative MI. Dobutamine stress echocardiography has the ability to identify patients with asymptomatic stress-induced ischemic myocardium andits increased risk for perioperative MI (p < 0,001). Equally important, for patients with clinical indicators of CAD but without DSE-inducible ischemia, no further cardiac evaluation is necessary.

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Documento generato il 06/08/20 alle ore 15:00:41