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Ann Thorac Surg 1994;58:622-629
© 1994 The Society of Thoracic Surgeons
Division of Cardiovascular Surgery, Department of Surgery, and Divisions of Cardiology, Pathology and Radiology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
* Address reprint requests to Dr Mickleborough, The Toronto Hospital, EN 13-217, 200 Elizabeth St. Toronto, Ont, Canada M5G 2C4.
Amiodarone therapy has been implicated as a risk factor for cardiothoracic surgical procedures. In patients undergoing map-guided surgical procedures for the treatment of ventricular tachycardia, we compared the perioperative course of those receiving long-term amiodarone therapy (n = 36) versus that in those not receiving the drug (n = 31). The two groups were similar with respect to age, sex, presenting symptoms, functional class, extent of coronary artery disease, presence of a ventricular aneurysm, technique of ventricular tachycardia abration, cross-clamp or pump time, the number of vessels grafted, the operative fluid balance, and a need for intraaortic balloon pump or inotropic agent support. In 5 patients receiving amiodarone, epinephrine was required to maintain a normal systemic vascular resistance and adequate arterial pressure. Postoperatively, 6 patients (17%) on amiodarone therapy suffered acute respiratory failure. In spite of aggressive therapy, 3 of these patients died. Only 1 patient not receiving amiodarone died of a stroke. We conclude that amiodarone therapy in patients undergoing open heart operations is associated with an increased risk of severe pulmonary complications (p = 0.03 by Fisher's exact test). Amiodarone therapy should be withheld in patients with ventricular tachycardia until they have been assessed as candidates for possible surgical intervention.
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