Predictive value of preoperative transthoracic echocardiography in patients undergoing adrenalectomy for pheochromocytoma.
BACKGROUND
Adrenalectomy for pheochromocytoma is a life-threatening procedure. Few echocardiographic assessments have been reported in patients undergoing adrenalectomy for pheochromocytoma.


METHODS
Sixty-three consecutive patients undergoing adrenalectomy for pheochromocytoma underwent routine preoperative M-mode and two-dimensional echocardiography, and Doppler examination. Abnormal echocardiographic findings were defined as left ventricular dilatation or dysfunction (left ventricular percentage fractional shortening < 30%), and/or left ventricular wall motion abnormalities, and/or left ventricular hypertrophy (left ventricular mass index > 110 g m(-2) in women and >134 g m(-2) in men) and/or valvular abnormalities. Physical characteristics, daily urinary metanephrine and normetanephrine excretions, preoperative functional limitation, pre-existing congestive heart failure, type and duration of surgery, and haemodynamic instability in the intra and postoperative periods were compared in patients with normal and abnormal echocardiographic findings.


RESULTS
Twenty-four out of 63 patients were found to have abnormal preoperative echocardiography. There was no difference between patients with normal and abnormal preoperative echocardiography as regards to the investigated criteria, except for pre-existing self-reported functional limitation and chest pain suggesting coronary artery disease.


CONCLUSIONS
The relevance of routine preoperative echocardiographic examination in patients scheduled for adrenalectomy for pheochromocytoma, who have no cardiac symptoms or clinical evidence of cardiac involvement, is questionable.
Devaux
B
B
Department of Anaesthesia and Critical Care, Universite Paris V - Rene Descartes, Hopital Cochin, Assistance Publique, Hopitaux de Paris, Paris, France.
Lentschener
C
C
Jude
N
N
Valensi
L
L
Pili-Floury
S
S
Dousset
B
B
Ozier
Y
Y
D000310:Adrenal Gland Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D000315:Adrenalectomy / Q000379:methods*; D002637:Chest Pain / Q000503:physiopathology; D003955:Diagnostic Tests, Routine; D004452:Echocardiography / Q000379:methods / Q000706:statistics & numerical data*; D015150:Echocardiography, Doppler / Q000379:methods; D004562:Electrocardiography; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000503:physiopathology; D008297:Male; D008676:Metanephrine / Q000652:urine; D008875:Middle Aged; D009647:Normetanephrine / Q000652:urine; D010673:Pheochromocytoma / Q000000981:diagnostic imaging* / Q000601:surgery; D011183:Postoperative Complications; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods* / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013997:Time Factors; D019564:Unnecessary Procedures
D009647:Normetanephrine; D008676:Metanephrine