ASSESSMENT OF THE RISK OF PERIOPERATIVE CARDIVASCULAR MORTALITY AND MORBIDITY IN PATIENTS UNDERGOING CAROTID ENDARTERECTOMY

Purpose: Various noninvasive investigations like dobutamine stress echocardiography, dipiradomole stress echocardiography and dipiradomole thalium scan may be carried out to asses the cardiovascular morbidity and mortality risk in patients who are planned to undergo peripheral arterial reconstruction. Despite high sensivity rates, these tests are expensive and time consuming. In this study we have used transthorasic echocardiography to asses the perioperative cardiovascular morbidity and mortality risk of the carotid endarterectomy candidates.

Methods: Transthorasic echocardiography was performed to determine the cardiac risk of the 103 patients who undergone carotid endarterectomy in our department between January 1999 and June 2003. The patients were prospectively assigned into two groups. Group A includes patients with left ventricule ejection fraction (EF) bigger than 50% and these patients were operated with general anesthesia. Group B includes patients with EF lesser than 50% and who were operated with regional anesthesia techniques.

Results: We do not have perioperative mortality and hypertension treated with oral antihypertensive drugs was seen as the only cardiovascular morbidity in 8 patients (7.8 %).

Conclusion: Transthorasic echocardiography is a preferable method in carotid endarterectomy candidates to assign the anesthesia method and prevent cardiovascular complications. (Turkish J Vasc Surg 2004;13(1): 1-4)