Coronary artery revascularization prior to abdominal nonvascular surgery

Abstract Background Does preoperative revascularization of the myocardium reduce cardiac risk in noncardiac surgery? The aim of this study was to evaluate the clinical effectiveness of preoperative cardioprotection by coronary artery revascularization in abdominal nonvascular surgery under general a...

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Published in:Cardiovascular revascularization medicine 2008, Vol.9 (1), p.18-23
Main Authors: Karapandzic, Vesna M, Vujisic-Tesic, Bosiljka D, Colovic, Radoje B, Masirevic, Vesna P, Babic, Dragan D
Format: Article
Language:English
Subjects:
Abdomen - surgery
Aged
Anesthesia, General
Biomarkers - blood
Cardiovascular
Coronary Angiography
Coronary Artery Bypass
Coronary artery disease
Coronary Artery Disease - complications
Coronary Artery Disease - diagnostic imaging
Coronary Artery Disease - therapy
Coronary artery revascularization
Elective Surgical Procedures
Electrocardiography
Female
Heart Diseases - etiology
Heart Diseases - mortality
Heart Diseases - prevention & control
Humans
Male
Noncardiac surgery
Perioperative cardiac complications
Postoperative Complications - etiology
Postoperative Complications - mortality
Postoperative Complications - prevention & control
Time Factors
Treatment Outcome
Troponin T - blood
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Summary:Abstract Background Does preoperative revascularization of the myocardium reduce cardiac risk in noncardiac surgery? The aim of this study was to evaluate the clinical effectiveness of preoperative cardioprotection by coronary artery revascularization in abdominal nonvascular surgery under general anesthesia. Materials and methods The observational clinical study included 111 consecutive patients with angiographically verified coronary artery disease. Two stratification groups of patients were compared, those with coronary artery revascularization (34 patients, 30.6%) and those without coronary artery revascularization (77 patients, 64.9%), in relation to frequency of perioperative cardiac complications. The patients were followed up until the 30th postoperative day. During operation and in the following 72 postoperative hours, the patients were monitored by continuous ST-T segment recording. Twelve-lead electrocardiography was performed immediately after surgery and on postoperative days 1, 2, and 7 as well as 1 day before discharge. Serum troponin T levels were controlled at 6, 24, and 96 h postoperatively. Results The number of patients with major cardiac complications was 0 (0.0%, n =34) in the revascularized myocardium group and 10 (12.9%, n =77) in the nonrevascularized myocardium group ( P
ISSN:1553-8389
1878-0938
DOI:10.1016/j.carrev.2007.04.001