title: Thallium redistribution does not predict perioperative cardiac complications following vascular surgery.
abstract: Utility of preoperative stress thallium scintigraphy (STS) was determined in 59 patients, thought to be at increased risk, prior to major vascular surgery from July 1987 to February 1990. Forty-seven had oral dipyridamole and 12 underwent exercise STS. Thallium redistribution (TR) was present in 61% (n = 36); fixed defects were present in 59% (n = 35); and some combination of defects was present in 76% (n = 45). Perioperative cardiac complications (CC = congestive heart failure [n = 3], ventricular arrhythmia [n = 2], and MI [n = 1]) were present in 8.5% (6 CC in 5 patients). Incidence of CC was 8.3% (3/36) in those with TR, and 8.7% (2/23) without TR (relative risk = 0.95). Perioperative MI was present in 2.8% (1/36) with TR vs. 0% (0/23) without. Though mortality was 3.4%, no perioperative deaths were from cardiac disease. Utility of STS is not clearly established for prediction of perioperative cardiac risk after major vascular surgery.
authors.affiliation: Department of Surgery, University of Kentucky Medical Center.
authors.forename: A
authors.initials: A
authors.lastname: Kazmers
authors.forename: J F
authors.initials: JF
authors.lastname: Kispert
authors.forename: L
authors.initials: L
authors.lastname: Roitman
authors.forename: E D
authors.initials: ED
authors.lastname: Endean
authors.forename: G L
authors.initials: GL
authors.lastname: Hyde
authors.forename: U Y
authors.initials: UY
authors.lastname: Ryo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000209:etiology; D006321:Heart / Q000000981:diagnostic imaging*; D006333:Heart Failure / Q000209:etiology; D006801:Humans; D007431:Intraoperative Complications; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D011300:Preoperative Care; D011336:Probability; D012189:Retrospective Studies; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon; D014656:Vascular Surgical Procedures
chemical_list: D013794:Thallium Radioisotopes