Does valve replacement without preoperative cardiac catheterization result in similar operative mortality and survival compared to routine catheterization in patients with valvular heart disease?
Routine preoperative cardiac catheterization is unnecessary before valve replacement and can be safely replaced by clinical and noninvasive assessment in most patients.
During the year 1978, the decision to perform cardiac catheterization in patients with valvular heart disease was delayed until clinical and noninvasive assessment have been completed. As a result, 184 patient underwent operation without invasive studies, and 59 had elective catheterization. Another 62 patients were referred during the same period for valve replacement after routine catheterization had been performed elsewhere. Age, sex distribution, symptoms, and cause of valve disease were similar in all three groups, although we managed emergencies and second operations more frequently without catheterization. In all patients, the preoperative diagnosis was confirmed, and no unexpected pathologic process was encountered. Operative mortality was the same in all three groups, and after two years of follow-up there was no difference in survival or symptoms. No uncorrected valve lesions became apparent in uncatheterized patients. We conclude that routine catheterization is unnecessary before valve replacement but can be reserved for specific indications in some patients.
Sutton et al. (Thu,) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: