Preoperative Cardiovascular Assessment and Late Cardiovascular Events after Elective Abdominal Aortic Aneurysm Repair

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Toshihiro Onohara1, Kentaro Inoue1, Tadashi Furuyama1

  • 1Department of Vascular Surgery, Kyushu Medical Center, Fukuoka, Japan.

Annals of Vascular Surgery
|July 19, 2015
PubMed

Insights

Preoperative cardiovascular evaluation before abdominal aortic aneurysm (AAA) repair is crucial. Findings like carotid stenosis and hypokinesis predict late cardiovascular events, highlighting the benefit of preoperative assessment.

Area of Science:

  • Vascular Surgery
  • Cardiology
  • Medical Diagnostics

Background:

  • High prevalence of cardiovascular disease necessitates preoperative evaluation for elective abdominal aortic aneurysm (AAA) repair.
  • Investigated the link between preoperative cardiovascular assessment and late cardiovascular events post-AAA repair.

Purpose of the Study:

  • To determine the association between preoperative cardiovascular evaluation and long-term cardiovascular outcomes after AAA repair.
  • To identify specific preoperative findings predictive of late cardiovascular events.

Main Methods:

  • Retrospective analysis of 438 patients undergoing elective AAA repair.
  • Preoperative assessments included echocardiography, serial coronary assessment (myocardial scanning or angiography), and carotid ultrasound.
  • Coronary revascularization status (preoperative, simultaneous, or remote history) was recorded.

Main Results:

  • 5-year survival: 86.0%; cardiovascular events: 5.7%; major adverse cardiovascular events (MACE): 11.5%.
  • Carotid stenosis correlated with adverse long-term outcomes.
  • Echocardiographic hypokinesis increased cardiovascular events and MACE.
  • Coronary assessment findings and revascularization history did not predict outcomes.

Conclusions:

  • Preoperative cardiovascular evaluation and treatment significantly reduce late cardiovascular events after AAA repair.
  • Specific findings like carotid stenosis and hypokinesis are important predictors of long-term risk.
Abstract

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