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Primary hyperaldosteronism: effect of adrenal vein sampling on surgical outcome Nwariaku FE; Miller BS; Auchus R; Holt S; Watumull L; Dolmatch B; Nesbitt S; Vongpatanasin W; Victor R; Wians F; Livingston E; Snyder WH 3rdArch Surg 2006[May]; 141 (5): 497-502; discussion 502-3HYPOTHESIS: Adrenal vein sampling is superior to computed tomography for subtype differentiation of primary hyperaldosteronism. DESIGN: Retrospective review. SETTING: University medical center. PATIENTS: Forty-eight patients (32 men and 16 women) with biochemically confirmed primary hyperaldosteronism. MAIN OUTCOME MEASURES: We compared demographic factors, results of biochemical and imaging studies (computed tomography and adrenal vein sampling), therapy, and patient outcomes. RESULTS: Mean +/- SEM adrenal nodule size was 1.54 +/- 0.2 cm. Adrenal vein sampling was performed in 41 (85%) of 48 patients, and it was successful in 39 (95%) of those 41 patients. Concordance between computed tomography and adrenal vein sampling was observed in 22 (54%) of the 41 patients. Thirty-two patients underwent successful laparoscopic adrenalectomy. There was 1 complication and no deaths. All 32 patients were cured of hypokalemia. CONCLUSION: Adrenal vein sampling is superior to image-based techniques for subtype differentiation of primary hyperaldosteronism.|*Adrenalectomy[MESH]|*Veins[MESH]|Adrenal Glands/*blood supply/diagnostic imaging/surgery[MESH]|Aldosterone/blood[MESH]|Catheterization, Peripheral[MESH]|Female[MESH]|Follow-Up Studies[MESH]|Humans[MESH]|Hyperaldosteronism/blood/*diagnosis/surgery[MESH]|Male[MESH]|Middle Aged[MESH]|Predictive Value of Tests[MESH]|Preoperative Care/*methods[MESH]|Retrospective Studies[MESH]|Tomography, X-Ray Computed[MESH]|Treatment Outcome[MESH] |
