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Preoperative Cardiac Risk Evaluation and Management in the Patient with Peripheral Vascular Disease: The Surgeon’s Perspective

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Textbook of Angiology

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Abstract

Perioperative cardiac events secondary to atherosclerotic coronary artery disease (CAD) remain a major cause of clinical concern.1-3 Although mortality rates are now quite low in patients undergoing peripheral vascular surgical procedures, associated deaths related to cardiac causes range from 33.4% to 100%.3-12 In addition, a perioperative myocardial infarction may be associated with significant morbidity. The prevalence of CAD in patients who have peripheral vascular disease (PVD) has been clearly demonstrated.11,13 Hertzer et al. found that among 1000 patients with PVD, severe correctable CAD was present in 25% and severe inoperable CAD in 6%. Only 8% of the patients had no angiographic evidence of CAD.11 The need for and importance of preoperatively identifying and stratifying the severity of CAD in patients undergoing peripheral vascular surgery is self-evident. The mere intensification of medical therapy based on preoperative risk assessment can reduce the risk of perioperative cardiac events.14 In addition, myocardial revascularization can provide both short- and long-term survival advantages in selected patients at high risk of CAD.11,15-17

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Authors
  1. Munier M. Nazzal
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  2. Timothy F. Kresowik
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  3. Jamal J. Hoballah
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  4. William J. Sharp
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  5. Beth A. Ballinger
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  6. John D. Corson
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Editor information

Editors and Affiliations

  1. International College of Angiology, Inc., USA

    John B. Chang MD, FACS, FICA (Chairman, Board of Directors, Director) (Chairman, Board of Directors, Director)

  2. Long Island Vascular Center, 1050, Northern Boulevard, Roslyn, NY, 11576, USA

    John B. Chang MD, FACS, FICA (Chairman, Board of Directors, Director) (Chairman, Board of Directors, Director)

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© 2000 Springer Science+Business Media New York

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Nazzal, M.M., Kresowik, T.F., Hoballah, J.J., Sharp, W.J., Ballinger, B.A., Corson, J.D. (2000). Preoperative Cardiac Risk Evaluation and Management in the Patient with Peripheral Vascular Disease: The Surgeon’s Perspective. In: Chang, J.B. (eds) Textbook of Angiology. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-1190-7_66

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  • DOI: https://doi.org/10.1007/978-1-4612-1190-7_66

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4612-7039-3

  • Online ISBN: 978-1-4612-1190-7

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