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[Indication for coronary revascularization in aortic surgery].

Y Soma1, K Kawada, R Yozu

  • 1Department of Surgery, School of Medicine, Keio University, Tokyo, Japan.

Nihon Geka Gakkai Zasshi
|September 1, 1989
PubMed
Summary
This summary is machine-generated.

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Patients with angina undergoing aortic surgery face high risks of coronary artery disease complications. Preoperative coronary revascularization is recommended for those with angina needing cardiac arrest during aneurysmectomy.

Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology
  • Vascular Surgery

Context:

  • Aortic aneurysm surgery presents a complex challenge regarding concurrent coronary artery disease.
  • Routine coronary angiography (CAG) is employed to assess coronary artery disease (CAD) in patients scheduled for aortic surgery.

Purpose:

  • To determine optimal management strategies for coronary artery disease in patients undergoing elective aortic aneurysm surgery.
  • To evaluate the incidence of perioperative complications related to CAD in patients with and without angina.

Summary:

  • In thoracic aortic aneurysm (TAA) surgery, 18 of 73 patients had significant CAD, with 3 experiencing angina. Two patients requiring coronary revascularization (CR) underwent concomitant CABG.
  • In abdominal aortic aneurysm (AAA) surgery, 38 of 76 patients had CAD, with 7 indicated for CR due to angina.

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  • Complications occurred in patients with angina who did not receive CR, while those without angina or with CR experienced no complications.

    • Impact:

    • Patients with angina undergoing aortic surgery are at high risk for CAD-related complications.
    • Coronary revascularization prior to aneurysmectomy is advised for patients with angina requiring cardiac arrest.
    • Patients without angina exhibit a low risk of perioperative myocardial ischemia during aortic surgery.