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[Evaluation of coronary risk in patients with subrenal abdominal aortic aneurysm]
B Eisenmann1, P Nicolini, A Charpentier
1Service de Chirurgie Cardio vasculaire, Hôpitaux Universitaires de Strasbourg.
Insights
Screening for and treating coronary artery disease is crucial for patients with abdominal aortic aneurysms. Addressing coronary risk before aortic surgery significantly reduces operative mortality.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Interventional Cardiology
Background:
- Atherosclerotic lesions frequently present in multiple locations.
- Operative mortality for non-ruptured infrarenal abdominal aortic aneurysms is primarily linked to coronary artery disease risk.
Purpose of the Study:
- To evaluate the impact of routine coronary angiography and revascularization on operative mortality in patients undergoing surgery for abdominal aortic aneurysms.
Main Methods:
- Coronary angiography was performed in 297 patients between January 1989 and the study's end.
- 192 patients underwent aneurysm repair; 42 received concurrent or prior coronary artery bypass grafting.
Main Results:
- Five deaths occurred, all attributed to coronary artery disease.
- No operative deaths were observed in patients who underwent coronary artery bypass grafting before or during aortic aneurysm repair.
Conclusions:
- Proactive screening and treatment of coronary artery disease are essential for improving outcomes in patients with abdominal aortic aneurysms.
- Addressing coronary lesions when morphologically feasible can significantly mitigate perioperative cardiac risk.
Abstract:
Atheroma lesions are often found in multiple localizations. In addition, operative mortality for aneurysms of the non-ruptured sub-renal aorta is mainly related to coronary risk. In an attempt to reduce coronary risk, coronarography was performed in all patients (n = 297) from January 1989. Operation for the aneurysm was performed in 192 patients (reasons for not operating were small size of the aneurysm, other contraindication). There were 5 deaths, all related to coronary artery disease. Coronary bypass was performed in 42 patients either before (n = 38) or at the same time (n = 4) as the operation for the aneurysm of the aorta. There were no operative deaths. These results clearly demonstrate the importance of search and treatment of associated coronary lesions in all patients with an aneurysm of the subrenal abdominal aorta. Coronary lesions should be treated whenever morphology allows.