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Operability With Safety Is Increased in Patients With Peripheral Vascular Diseases

Sateesh C. Babu, MD; P. V. Pathanjali Sharma, MD; Alfio Raciti, MD; Carlos H. Mayr, Jr, MD; Nazmi A. Elrabie, MD; Roy H. Clauss, MD; William M. Stahl, MD; Louis R. M. Del Guercio, MD

Arch Surg. 1980;115(11):1384-1386.

Abstract
• Poor cardiopulmonary reserve was demonstrated in a group of 75 elderly patients undergoing elective vascular reconstruction when cardiovascular hemodynamics were analyzed with the automated physiologic profile (APP) preoperatively. Only 25 patients (33.3%) had normal left ventricular function (LVF) and did not need any corrective therapy before surgery. Increment in preload was necessary in 20 patients (26.7%) to improve myocardial function; 30 patients (40%) revealed abnormal LVF and hence required pharmacologic modulation and preload adjustment, inotropic support, and afterload reduction to enhance the ventricular performance. Conventional methods of clinical evaluation did not reveal the degree of compromised ventricular function and potential high risk of surgical morbidity and mortality in many of these patients. The APP disclosed subtle and important physiologic aberrations indicating modification of anesthetic and operative procedures and precise modulation of physiologic factors. Optimization was achieved in all except two patients, and only one was denied the benefits of vascular reconstruction.

(Arch Surg 115:1384-1386, 1980)

Author Affiliations
From the Department of Surgery, New York Medical College-Metropolitan Hospital Center.

Footnotes
Accepted for publication July 21, 1980.

Read before the 28th annual scientific meeting of the International Cardiovascular Society, Chicago, June 28, 1980.

Reprint requests to Department of Surgery, Metropolitan Hospital Center, 1901 First Ave, New York, NY 10029 (Dr Babu).

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