Safety of same-day coronary angiography in patients undergoing elective valvular heart surgery

To maximize patient convenience, we developed a protocol for coronary angiography the same day as elective valvular surgery.

We analyzed the medical records from a single surgical service of 226 consecutive patients who had undergone cardiac catheterization on the day of elective valvular repair or replacement between August 1, 2000, and August 30, 2004. The rates of renal failure (creatinine >2.0 mg/dL and 2 times the preoperative level), hemodialysis, continuous renal replacement therapy, and mortality were evaluated.

Patients undergoing same-day angiography had a mean age of 65.6 plus-or-minus 12.1 years, and 33% were female. Of the study patients, 11.1% were diabetic, with a mean ejection fraction of 61% plus-or-minus 10%, and 28.3% had coronary artery disease severe enough to require bypass grafting. One patient died within 30 days of surgery; the overall mortality was 0.4%. Postoperatively, serum creatinine levels increased an average of 0.1 mg/dL (P<.001) in patients undergoing same-day coronary angiography. Four patients had transient renal failure (1.8%), 2 of whom required temporary hemodialysis.

In properly selected patients, same-day coronary angiography is safe and has little impact on renal function. This protocol offers a simple way to reduce the number of hospital visits required by patients undergoing elective valvular surgery.