[Indications for cardiac surgery on the basis of noninvasive examination methods with major emphasis on...

Over the years 1983-1988 cardiosurgical procedures with extracorporeal circulation without catheterization of the heart were indicated in 191 patients, representing 19.8% of all the patients operated on at extracorporeal circulation (n--962). Indications for surgery were made on the basis of the clinical state of the patient and of the results of noninvasive methods, with main emphasis on echocardiographic findings. The close relationship between the methodological level of ultrasound diagnosis and the increasing number of patients operated on without preceding hemodynamic examination is documented (13% in 1983, 35% in 1988). With a few exceptions, noninvasive techniques provide a sufficient amount of relevant information definitely deciding on the indication for operation without catheterization in heart tumors and infective endocarditis, in about one half of the patients with dissecting aneurysm of the aorta and with deranged function of valvular prostheses, in one third of the patients with mitral defects, and in about one third of the patients with atrial septal defects. On the basis of their own results, the authors present the criteria for indicating cardiosurgical procedures without catheterization of the heart in the diagnoses studied. The diagnostic conclusion was confirmed by the operative finding in 99.5%. The obtained results are comparable with those reported by authors from abroad and demonstrate the significant medical and economic contribution.