[Perioperative cardiac complications of pulmonary operations in patients with/without coronary stenosis].
It has been suggested that the presence of ischemic heart disease correlates with an increased risk of cardiac infarction and fatal arrhythmia following noncardiac operations. To prevent these complications, coronary arteriographies were performed on 55 patients before pulmonary surgery for the assessment of the risk of perioperative cardiac complications. A coronary artery obstruction, with a 50% or greater reduction in the internal diameter was recognized on 21 patients (Group 1) and the other 34 patients showed no significant coronary stenotic lesions (Group 2). Discriminant analysis revealed that cardiac index (p less than 0.025), blood sugar level (p less than 0.05), hyperlipidemia (p less than 0.05) and postoperative cardiac failure (p less than 0.005) correlated independently with coronary artery stenosis. Postoperative cardiac complications were observed in the form of atrial arrhythmias (11%), ventricular arrhythmias (16%) and ischemic ECG findings (17%) in all cases. The rate of occurrence of these complications were not different between the two groups. However, the need for therapeutic procedures for perioperative circulatory failure (18%) was much greater in group 1 (p less than 0.005). This study supports the merits of preoperative coronary arterial angiography and the estimation of the left ventricular function in reducing pulmonary perioperative risk.
Itaoka
T
T
First Department of Surgery, Tokyo Women's Medical College, Japan.
Obara
T
T
Kei
J
J
Onuki
T
T
Yokoyama
M
M
Nitta
S
S
D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000209:etiology*; D016009:Chi-Square Distribution; D003251:Constriction, Pathologic; D003327:Coronary Disease / Q000209:etiology* / Q000503:physiopathology; D016002:Discriminant Analysis; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology*; D008168:Lung / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D016277:Ventricular Function, Left