Murali Chakravarthy1, Dattatreya Prabhakumar1, Benak Shivalingappa1, Sonali Rao1, Sumant Padgaonkar1, Rajathadri Hosur1, Chidananda Harivelam1, Vivek Jawali2
1 Department of Anesthesia, Critical Care, and Pain Relief, Fortis Hospital, Bengaluru, Karnataka, India
2 Department of Cardiovascular Surgery, Fortis Hospital, Bengaluru, Karnataka, India
Background: Presence of peripheral vascular disease enhances surgical risk in cardiac surgical patients. Prior knowledge of peripheral arterial disease may help the physician make changes in the monitoring and cardiopulmonary bypass cannulation plans. It is claimed that the incidence of peripheral vascular disease in cardiac surgical patients ranges from 11 to 30%. Aims: This study was conducted to understand the characteristics of peripheral vascular disease and their implication on cardiac surgery. Settings and Design: This was a prospective study undertaken in a tertiary referral hospital. Materials and Methods: All adult patients who underwent cardiac surgery during the period of six months were included. A Doppler examination of the neck, upper limb, abdomen and lower limb was carried out by our inhouse radiologist. The incidence of peripheral vascular disease, the implication on invasive pressure monitoring site and cannulation for cardiopulmonary bypass or intraaortic balloon pump or extracorporeal membrane oxygenation were made note of. Results: During the said period, six hundred twenty eight patients underwent cardiac surgery, of whom five hundred and sixty-one patients who underwent CABG surgery. All these were subjected to Doppler examination. We observed peripheral arterial disease in 105 patients (20%). In general men suffered from PAD more often than women. Monitoring site of invasive arterial pressure, the choice of beating heart surgery, insertion of intraaortic balloon pump, femoral arterial route for cardiopulmonary bypass were some of the decision that were altered. Conclusions: Performing Doppler examination in cardiac surgical patients may yield important data that might prevent complications and support patient safety.
Department of Anesthesia, Critical Care and Pain Relief, Fortis Hospitals, Bengaluru . 560 076, Karnataka
Source of Support: None, Conflict of Interest: None
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