Equilibrium radionuclide angiocardiography prior to elective abdominal aortic surgery

Prediction of cardiac risk before abdominal aortic reconstruction: Comparison of a revised Goldman Cardiac Risk Index and radioisotope ejection fraction

“…Studies looking at whether a low LVEF is an independent risk factor for cardiac events in the postoperative period have produced conflicting results. 7 Some studies report that it is, [18][19][20][21][22][23][24][25] and others report good results in patients with poor ejection fractions (LVEF Ͻ 35%). 26,27 Of eight studies that showed a positive relation between decreased preoperative ejection fraction and postoperative mortality or morbidity, five were prospective [18][19][20][21][22] and one retrospective 23 and, in two, the nature of the study was not clearly stated.…”

“…7 Some studies report that it is, [18][19][20][21][22][23][24][25] and others report good results in patients with poor ejection fractions (LVEF Ͻ 35%). 26,27 Of eight studies that showed a positive relation between decreased preoperative ejection fraction and postoperative mortality or morbidity, five were prospective [18][19][20][21][22] and one retrospective 23 and, in two, the nature of the study was not clearly stated. 24,25 It has been suggested that, in the perioperative phase, poor left ventricular function is mainly predictive of congestive heart failure 18 and, in critically ill patients, death.…”

“…This feature has seldom been addressed in previous reports, and we were able to identify only one other similar study in the literature. 21 Despite this conflicting evidence about the predictive value of the resting LVEF, MUGA scan remains the second most popular preoperative cardiac assessment tool amongst vascular surgeons and anesthetists in the United Kingdom. 4,5 Although the use rate varies considerably, it is estimated that 13% to 19% of the vascular units in the United Kingdom, and 39% of those to which the investigation is available, use MUGA scan as the investigation of choice.…”

Routine Measurement of Radioisotope Left Ventricular Ejection Fraction Prior to Vascular Surgery: Is it Worthwhile?

“…Only two studies have addressed the importance of myocardial wall motion abnormalities in predicting postoperative cardiac complications. 21,30 It appears that patients with wall abnormalities both with, or without an abnormal ejection fraction, are more likely to suffer a postoperative cardiac problem. A further study demonstrated that ventricular wall motion abnormalities were also associated with reduced overall survival after successful lower limb bypass surgery.…”

“…*21 Ejection fraction and late cardiac outcome Preoperative LVEF has also been shown to be associated with significantly reduced overall longterm survival after successful vascular surgery.15,42 However, McCann and Wolfe found no such association in a group of patients undergoing abdominal aortic aneurysm repair and they concluded that patients should not be denied aneurysm resection solely on the basis of LVEF.17 When considering patients with severely impaired LV function (LVEF of 35% or less), Kazmers et al found that patients with an LVEF of 29% or less formed a subgroup at even greater survival disadvantage and recommended that surgery should be performed for only the most compelling indications.…”