Relationship Between Preoperative Angiography And Cardiac Complication Of Chest Surgery Perioperative Period

Objective: To evaluate the clinical value of damage brought by going on angiograthy and the benefit brought by changing therapeutic schemes after angiograthy perioperative period in patients underwent intermediate risk surgery. And investigate whether angiography is the risk factor of the cardiac complication of perioperation period or not, and provide guidance for clinical practice. We use Gensini Score in patients’ coronary angiography results, analysis complication rate in difference terms grouping by score, and preliminary evaluate the relationship between Gensini Score and cardiac complication of perioperation period.Methods: A total of 225 patients(aged 46-81 years, average age was 63.61) were enrolled in this study, including 53 patients with angiography and 172 patients without angiography. All of them diagnosed CAD by the routine examinations, and suffered pulmonary resection or esophagectomy, a few of them canceled the operation. Patient information such as age, gender, hypertension, smoking, type 2 diabetes mellitus, chronic pulmonary diseases, cardiac sonography and angiography was gathered before surgery. During operation and in the following 72 postoperative hours, the patients were monitored by continuous ST-T segment, BP, blood oxygen saturation recording, Twelve-lead electrocardiography was performed immediately when patients didn’t feel good. Serum troponin T levels were collected, too. Every patient had an interview to evaluate adverse cardiovascular events during the 7 days postoperation, such as high BP( ≥ 160/100 mm Hg), low BP( ≤90/60 mm Hg), Significant arrhythmias, angina, troponin I elevation, Recent MI, cardiac deaths. According to the angiography between the angiography and the control group by logistic analysis, we also used Gensini Score charged angiograthy, and analyzed the incidence of cardiovascular events between the two groups was compared. And also evaluate the relationship between the Gensini Score and cardiac complication of perioperative period. Meanwhile evaluate the value of angiography.Results:1 There are differences between the angiograthy and the control group in age, gender, hypertension, smoking, type 2 diabetes mellitus and chronic pulmonary diseases, but there is no statistically significant difference.2 There is no statistically significant difference between the angiograthy and the control in clinical type of CHD.3 This study show that the angiography has nothing to do with the cardiac complication in patients underwent intermediate risk surgery.4 People who had angiogray will get the clear cardiac artery conditions. Doctors depend on these conditions may change treatment, some even canceled surgery. 7 patients of the angiograthy canceled surgery(13.73% of the angiograthy), 14 patients suffered the surgery after improved the heart by transferring to cardiovascular department. The angiograthy has a higher cardiovascular complications than the control, but there is no statistically significant difference.5 The angiograthy has a longer time than the control group cost in hospital, and the difference have statistical sense. In the angiograthy, less people transffered to ICU, and less time spent in ICU, but higher cost than the control group.6 The higher Gensini Score, the higher cardiovascular complications.Conclusions:1 Even though angiogray is invasive examination, plaque disruption, contrast media renal damage and arterial thrombosis may happened in the angiograthy, and there may be some other cardiovascular complications in short time after the invasive examination. But doctors depend on these conditions may make the treatment plan optimization. In conclusion, it has no influence on cardiac complication of perioperative period, and it can help us to get strict examination.2 Angiograthy is the better examination for value the risk of perioerative period, and it doesn’t increase the incidence of cardiac complication, while it can change treatment made by doctors, even cancel the surgery, and make the time in hospital longer, and higher cost in the hospital. But in the angiograthy, less serious cardiac complications happened, and less people transferred to ICU.3 Angiograthy should be considered when people in high heart risk, and even though surgery is allowed, much more monitoring sets should be taken, to get lower complications.4 The higher Gensini Score, the higher cardiovascular complications.