title: Preoperative cardiac assessment in patients undergoing major vascular surgery.
abstract: The aim of this study was to evaluate the effectiveness of a preoperative standardized cardiac assessment in patients undergoing major vascular surgery. From January 2005 to December 2006, 1446 elective interventions for major vascular diseases (carotid stenosis, CS; abdominal aortic aneurysm, AAA; peripheral arterial obstructive disease, PAOD) were performed; 1090 out of these patients underwent preoperative diagnostic assessment on an outpatient basis. Thirty-day results in terms of cardiac mortality and morbidity rates were recorded. Patients suffered from a CS in 578 cases (53%), an AAA in 303 cases (27.8%) and a PAOD in 209 cases (19.2%). Four hundred thirty-two patients (39.6%) underwent further evaluation of cardiac functional capacity with non-invasive stress testing. Sixteen patients were successfully treated prior to vascular surgery. Thirty-day cardiac mortality and morbidity rates were 0.2% and 3.9%, respectively. A positive preoperative non-invasive stress testing did not affect 30-day cardiac outcomes. In conclusion, the use of an accurate preoperative cardiac assessment allowed us to obtain satisfactory perioperative results in patients undergoing major vascular surgery. Routine preoperative evaluation with non-invasive stress testing did not seem to improve perioperative cardiac results.
authors: Department of Vascular Surgery, University of Florence, Florence, Italy. nicola.trois@alice.it
authors: Nicola
authors: N
authors: Troisi
authors: Raffaele
authors: R
authors: Pulli
authors: Walter
authors: W
authors: Dorigo
authors: Patrizia
authors: P
authors: Lo Sapio
authors: Carlo
authors: C
authors: Pratesi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D025401:Echocardiography, Stress; D017558:Elective Surgical Procedures; D004562:Electrocardiography; D057510:Endovascular Procedures / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006331:Heart Diseases / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D006334:Heart Function Tests; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging; D011237:Predictive Value of Tests; D011300:Preoperative Care; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000401:mortality