| Preoperative transthoracic echocardiography in patients older than 90 years undergoing noncardiac surgery |
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Yoo Ri Kim, In Jeong Cho, Gil Ja Shin, Wook Bum Pyun |
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| 90세 이상 초고령 환자에서 수술 전 심장 초음파 검사 분석 |
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김유리, 조인정, 신길자, 편욱범 |
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| Abstract |
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Background/Aims: Adverse cardiac events pose a significant perioperative risk to patients undergoing noncardiac surgery, especially
geriatric patients. This study presents resting echocardiography data for a population older than 90 years.
Methods: We performed transthoracic echocardiography in 108 patients who were older than 90 years and scheduled to undergo
noncardiac surgery between November 1, 2004, and September 22, 2008, and evaluated their medical histories and electrocardiograms.
Results: The 108 patients included 73 (67.3%) women and 35 (32.7%) men with a mean age of 92.05±2.77 years (range 90-104).
Their medical histories included hypertension in 38.9% and diabetes mellitus in 15.7%. The average left ventricular end diastolic
dimension and ejection fraction were 49.0±6.3 mm and 62.9±11.1%, respectively. Six (5.6%) patients had clinically significant
aortic regurgitation and seven (6.5%) had mitral regurgitation as pathologic changes of aging. Six patients had mild to moderate
aortic stenosis, found incidentally, that did not affect the clinical decision regarding the scheduled operation. The diastolic parameters
showed that most of the patients (87%) had grade I relaxation abnormalities. The average mitral inflow E/A, deceleration time,
and E/E's were 0.69±0.33, 266±82 msec, and 11.15±3.88, respectively.
Conclusions: Echocardiography cannot predict all of the postoperative cardiovascular complications and risks, but it is useful for
screening for significant left ventricular dysfunction, valvular abnormalities, and as a guide for managing extremely old patients in
the perioperative period. (Korean J Med 77:193-199, 2009) |
| Key Words:
Nonagenarians; Echocardiography; Preioperative |
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