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Cardiac risk of noncardiac surgery in patients with asymmetric septal hypertrophy.

Publication ,  Journal Article
Haering, JM; Comunale, ME; Parker, RA; Lowenstein, E; Douglas, PS; Krumholz, HM; Manning, WJ
Published in: Anesthesiology
August 1996

BACKGROUND: Many data are available regarding cardiac risk in patients with coronary artery disease undergoing noncardiac surgery, but few data are available regarding risk for patients with hypertrophic cardiomyopathy and asymmetric septal hypertrophy. METHODS: Seventy-seven patients with asymmetric septal hypertrophy were identified in whom an echocardiogram had been performed within 24 months of noncardiac surgery. Patients' charts were reviewed for data regarding surgical operations, including length of surgery, type of anesthesia, and intravascular monitoring used. Data regarding adverse perioperative cardiac events also were gathered. RESULTS: Forty percent (n = 31) of patients had one or more adverse perioperative cardiac events, including one patient who had a myocardial infarction and ventricular tachycardia that required emergent cardioversion. There were no perioperative deaths. All 31 patients had minor outcomes. Of the 77 patients, perioperative congestive heart failure developed in 12 (16%). Factors associated with adverse cardiac events were increasing length of surgical time (P < 0.01) major surgery (P < 0.05), and intensity of monitoring (P < 0.05). Age, gender, resting outflow tract gradient, systolic anterior motion of the anterior mitral leaflet, prior myocardial infarction, severity of mitral regurgitation, type of anesthetic, septal thickness, and the interval between echocardiogram and surgery were not associated with the occurrence of adverse cardiac events. CONCLUSION: Patients with asymmetric septal hypertrophy undergoing noncardiac surgery have a high incidence of adverse cardiac events, frequently manifested as congestive heart failure. However, irreversible cardiac morbidity and mortality was extremely low. Important independent risk factors for adverse outcome in all patients include major surgery and increasing duration of surgery.

Duke Scholars

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Published In

Anesthesiology

DOI

ISSN

0003-3022

Publication Date

August 1996

Volume

85

Issue

2

Start / End Page

254 / 259

Location

United States

Related Subject Headings

  • Tachycardia, Ventricular
  • Risk Factors
  • Postoperative Complications
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Humans
  • Female
  • Echocardiography
  • Cardiomyopathy, Hypertrophic
 

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Haering, J. M., Comunale, M. E., Parker, R. A., Lowenstein, E., Douglas, P. S., Krumholz, H. M., & Manning, W. J. (1996). Cardiac risk of noncardiac surgery in patients with asymmetric septal hypertrophy. Anesthesiology, 85(2), 254–259. https://doi.org/10.1097/00000542-199608000-00005
Haering, J. M., M. E. Comunale, R. A. Parker, E. Lowenstein, P. S. Douglas, H. M. Krumholz, and W. J. Manning. “Cardiac risk of noncardiac surgery in patients with asymmetric septal hypertrophy.Anesthesiology 85, no. 2 (August 1996): 254–59. https://doi.org/10.1097/00000542-199608000-00005.
Haering JM, Comunale ME, Parker RA, Lowenstein E, Douglas PS, Krumholz HM, et al. Cardiac risk of noncardiac surgery in patients with asymmetric septal hypertrophy. Anesthesiology. 1996 Aug;85(2):254–9.
Haering, J. M., et al. “Cardiac risk of noncardiac surgery in patients with asymmetric septal hypertrophy.Anesthesiology, vol. 85, no. 2, Aug. 1996, pp. 254–59. Pubmed, doi:10.1097/00000542-199608000-00005.
Haering JM, Comunale ME, Parker RA, Lowenstein E, Douglas PS, Krumholz HM, Manning WJ. Cardiac risk of noncardiac surgery in patients with asymmetric septal hypertrophy. Anesthesiology. 1996 Aug;85(2):254–259.

Published In

Anesthesiology

DOI

ISSN

0003-3022

Publication Date

August 1996

Volume

85

Issue

2

Start / End Page

254 / 259

Location

United States

Related Subject Headings

  • Tachycardia, Ventricular
  • Risk Factors
  • Postoperative Complications
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Humans
  • Female
  • Echocardiography
  • Cardiomyopathy, Hypertrophic