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Titolo:
Cardiac investigation and intervention prior to thoraco-abdominal aneurysmrepair: Coronary angiography in 35 patients
Autore:
Brooks, MJ; Mayet, J; Glenville, B; Foale, R; Wolfe, JHN;
Indirizzi:
St Marys Hosp, Waller Dept Cardiol, London W2 1NY, England St Marys Hosp London England W2 1NY Dept Cardiol, London W2 1NY, England St Marys Hosp, Reg Vasc Unit, London W2 1NY, England St Marys Hosp London England W2 1NY eg Vasc Unit, London W2 1NY, England
Titolo Testata:
EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
fascicolo: 5, volume: 21, anno: 2001,
pagine: 437 - 444
SICI:
1078-5884(200105)21:5<437:CIAIPT>2.0.ZU;2-L
Fonte:
ISI
Lingua:
ENG
Soggetto:
DOBUTAMINE STRESS ECHOCARDIOGRAPHY; PERIPHERAL VASCULAR-DISEASE; NONCARDIAC SURGERY; ARTERY DISEASE; PREOPERATIVE ASSESSMENT; RISK STRATIFICATION; AORTIC-ANEURYSM; EXPERIENCE; OPERATIONS; BYPASS;
Keywords:
thoraco-abdominal aortic aneurysm; dobutamine stress echocardiography; coronary angiography;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
41
Recensione:
Indirizzi per estratti:
Indirizzo: Wolfe, JHN St Marys Hosp, Waller Dept Cardiol, Praed St, London W2 1NY, England St Marys Hosp Praed St London England W2 1NY n W2 1NY, England
Citazione:
M.J. Brooks et al., "Cardiac investigation and intervention prior to thoraco-abdominal aneurysmrepair: Coronary angiography in 35 patients", EUR J VAS E, 21(5), 2001, pp. 437-444

Abstract

Objective: retrospective studies indicate a high risk of cardiac events inpatients undergoing thoraco-abdominal aneurysm repair. We aimed to determine the prevalence of coronary disease in these patients, define the role ofnon-invasive cardiac testing and assess the short-term outcome of coronaryre-vascularisation. Design: a prospective cohort study of consecutive patients referred to a single surgeon. Materials and Methods:forty patients recruited over 26 months (Type I, 6; II, 11; III, 8; IV, 15). Dobutamine stress echocardiography coronary angiography and coronary re-vascularisation (PTCA or CABG) were performed according to a pragmatic protocol. Main outcome measures mere the prevalence of coronary artery disease, sensitivity and specificity of clinical assessment and non-invasive cardiac testing, and adverse events associated with coronary investigation and intervention. Results: seven patients (17.5%) were stratified as having high perioperative cardiac risk. The majority of patients (23, 57.5%) had no cardiac risk factor other than the operation type. Five patients (12.5%) had inducible ischaemia on non invasive testing. Fourteen patients (40%) had haemodynamically significant coronary artery stenoses, of whom 12 (34%) underwent coronary revascularisation. Dobutamine stress echocardiography demonstrated 100% specificity and 71% sensitivity for the detection of significant coronary artery lesions. Coronary re-vascularisation by three-vessel bypass grafting was complicated by non-fatal stroke in one patient. Thirty-five patients (87.5%) proceeded to aneurysm repair. No patient who had been adequately investigated suffered a cardiac complication. Conclusions: the 40% prevalence of coronary artery disease in these patients is comparable to that of other patients undergoing arterial surgery. Non-invasive testing proved beneficial, both in screening low-risk patients and planning intervention in patients at higher risk. An aggressive approach to intervention was associated with art acceptable complication rate and favourable short-term outcome.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/03/20 alle ore 15:36:37