1992
DOI: 10.1001/jama.1992.03490020058031
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Monitoring for Myocardial Ischemia During Noncardiac Surgery

Abstract: When compared with preoperative clinical data and intraoperative monitoring using two-lead ECG, routine monitoring for myocardial ischemia with TEE or 12-lead ECG during noncardiac surgery has little incremental clinical value in identifying patients at high risk for perioperative ischemic outcomes.

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Cited by 117 publications
(5 citation statements)
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“…There are few data on the value of transesophageal echocardiography to detect transient wall motion abnormalities in predicting cardiac morbidity in noncardiac surgical patients (72,73). Experience to date suggests that the incremental value of this technique for risk prediction is small (72).…”
Section: Transesophageal Echocardiographymentioning
confidence: 99%
See 1 more Smart Citation
“…There are few data on the value of transesophageal echocardiography to detect transient wall motion abnormalities in predicting cardiac morbidity in noncardiac surgical patients (72,73). Experience to date suggests that the incremental value of this technique for risk prediction is small (72).…”
Section: Transesophageal Echocardiographymentioning
confidence: 99%
“…There are few data on the value of transesophageal echocardiography to detect transient wall motion abnormalities in predicting cardiac morbidity in noncardiac surgical patients (72,73). Experience to date suggests that the incremental value of this technique for risk prediction is small (72). Guidelines for appropriate use of transesophageal echocardiography have been published by the American Society of Anesthesiologists and the Society of Cardiovascular Anesthesiologists (74).…”
Section: Transesophageal Echocardiographymentioning
confidence: 99%
“…Two investigators independently analyzed all the clinically obtained 12-lead ECGs using the Minnesota Codes, 12,13 which have been used in prior studies to determine evidence of MI and other ECG abnormalities in patients undergoing surgery in a standardized fashion. 14,15 The specificity of the Minnesota Codes to diagnose recent or old MIs has been found on autopsy studies to be high (88-98%). 16 See Appendix 1 for the definitions of Q-wave, STjunction, and T-wave abnormalities as defined by the Minnesota Code.…”
Section: Ecg Analysismentioning
confidence: 99%
“…It can monitor the ambulant patient at all times, except in the shower or bath, and monitoring with two leads does not cause underestimation of the true incidence of myocardial ischaemia. 17 Twelve patients were withdrawn from analysis because of insufficient monitoring time. Before operation we had emphasized the voluntary nature of this study and these 12 patients, already with chest drains, ECG, pulse oximeter, arterial pressure and added oxygen, found it one tie too many and requested its removal.…”
Section: Study Design and Limitationsmentioning
confidence: 99%