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Preoperative cardiac screening before peripheral vascular operations.

K M Jain, K D Patil, U S Doctor

    The American Surgeon
    |February 1, 1985
    PubMed
    Summary
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    Radionuclide angiography (RNA) effectively identifies cardiac risk before peripheral vascular operations. Patients with normal RNA had no myocardial infarctions, suggesting routine coronary angiography may be unnecessary.

    Area of Science:

    • Cardiology
    • Vascular Surgery
    • Diagnostic Imaging

    Background:

    • Myocardial infarction is a significant cause of death and complications following peripheral vascular surgery.
    • Accurate preoperative cardiac risk assessment is crucial for patient outcomes.

    Purpose of the Study:

    • To evaluate the utility of radionuclide angiography (RNA) in assessing cardiac risk in patients undergoing peripheral vascular operations.
    • To determine if RNA can guide decisions regarding further cardiac interventions.

    Main Methods:

    • Seventy-eight patients undergoing peripheral vascular operations were assessed using radionuclide angiography (RNA).
    • Abnormal RNA findings prompted further investigation, including coronary angiography in 27 patients.
    • Surgical plans were modified in 11 patients based on RNA results.

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    Main Results:

    • 53 out of 78 patients had abnormal RNA studies.
    • No myocardial infarctions occurred in patients with normal RNA findings.
    • Two fatal postoperative myocardial infarctions (2.2% mortality) occurred in patients with abnormal RNA.

    Conclusions:

    • Radionuclide angiography (RNA) is an effective tool for identifying cardiac risk in patients undergoing peripheral vascular surgery.
    • Normal RNA results indicate a minimal risk of myocardial infarction, potentially obviating the need for routine coronary angiography.
    • RNA findings can influence surgical planning and the necessity for preoperative cardiac interventions like aortocoronary bypass.