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European Heart Journal 1997 18(Supplement D):86-96; doi:10.1093/eurheartj/18.suppl_D.86
Copyright © 1997 by the European Society of Cardiology.
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© 1997 The European Society of Cardiology

Prognostic value of dobutamine—atropine stress echocardiography for peri-operative and late cardiac events in patients scheduled for vascular surgery

D. Poldermans*,, R. Rambaldi, P. M. Fioretti, E. Boersma, I. R. Thomson{dagger}, M. R. H. M. van Sambeek* and H. van Urk*

* Thoraxcenter and Department of Surgery Rotterdam, The Netherlands
University Hospital Rotterdam-Dijkzigt and Erasmus University Rotterdam, The Netherlands
{dagger} Department of Anesthesia, University of Manitoba Winnipeg, Manitoba, Canada

Correspondence: Don Poldermans, MD, Department of Surgery, University Hospital Rotterdam-Dijkzigt. Dr Molewaterplein 40, 3015 GD Rotterdam, The Netherlands

Cardiac events in the peri-operative phase and late after non-cardiac vascular surgery are a major cause of morbidity and mortality. Numerous tests and diagnostic strategies — usually consisting of a combination of analysis of clinical risk factors and additional non-exercise dependent stress testing, such as thallium scintigraphy, or stress echocardiography — have been developed to preoperatively identify patients with increased risk. The tests ideally should identify three subpopulations in a group with a high prevalence of coronary artery disease; (1) low-risk patients who can be referred for surgery without extra cardiac intervention, (2) patients whose peri-operative cardiac risk outweighs the potential benefits of vascular surgery, (3) patients whose risk may be reduced by peri-operative therapeutic interventions.

This review will discuss the prognostic value of dobutamine stress echocardiography for risk stratification in patients scheduled for non-cardiac vascular surgery and discuss guidelines for future management.

Key Words: stress echocardiography • vascular surgery


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