Russian Heart Failure Journal 2010year Left ventricular systolic dysfunction and risk of postoperative complications in patients with non-coronary artery basins surgery
Left ventricular systolic dysfunction and risk of postoperative complications in patients with non-coronary artery basins surgery
Sumin A. N., Bezdenezhnykh A. V., Evdokimov D. O., Korok E. V., Ivanov S. V., Barbarash O. L., Barbarash L. S.
Keywords: postoperative complications, left ventricular systolic dysfunction
Urgency. Recent trend is the increased rate of non-cardiac surgery in patients with CHF. The relationship between asymptomatic left ventricular (LV) dysfunction and immediate results of surgical treatment remains unclear. Aim. To study the effect of LV systolic dysfunction on the development of perioperative complications in patients undergoing reconstructive operations on non-cardiac arterial basins. Materials and methods. Retrospective analysis of 350 case histories of patients (301 men and 49 women, 61.0±0.4 years) underwent surgery on carotid basin, aorta and arteries of lower extremities. Three groups of patients: with EF <40 % (n=14), with EF 40–50 % (n=33) and EF >50 % (n=303). Before the surgery clinical history data was evaluated, echocardiography, color duplex scanning and angiography of non-cardiac vascular basins, coronaroangiography (CAG) were performed. Endpoints of the study were: 30‑day mortality, development of any complications, including major vascular events (MI, stroke), bleeding. Results. No significant difference in complication rates between groups with different degree of systolic dysfunction severity was detected. Perioperative MI and cerebrovascular complications occurred only in patients with preserved LV systolic function (1.98 % each), the difference was not statistically significant. Significant change of at least one coronary artery was detected with CAG in 85.1 % of patients with LV systolic dysfunction and involvement of 3 coronary arteries and / or stenosis of left coronary artery ≥50 % – in 36.2 % of cases. Myocardial revascularization was performed in 40.4 % of patients with LV systolic dysfunction, that was higher compared to control (22 %). Thus, the presence of LV asymptomatic systolic dysfunction did not influence the rate of perioperative complications and mortality in case of non-cardiac vascular surgery. And the patients received optimized drug therapy and preventive myocardial revascularization.
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Sumin A. N., Bezdenezhnykh A. V., Evdokimov D. O. et al. Left ventricular systolic dysfunction and risk of postoperative complications in patients with non-coronary artery basins surgery. Russian Heart Failure Journal. 2010;11(6):347-354.