Selective evaluation and management of coronary artery disease in patients undergoing repair of abdominal aortic aneurysms. A 16-year experience.

摘要: Reduction of cardiac mortality associated with abdominal aortic aneurysm (AAA) repair remains an important goal. Five hundred consecutive urgent or elective operations for infrarenal nonruptured AAA were reviewed. Patients divided into three groups based on preoperative status: group I (n = 260, 52%), no clinical electrocardiographic (ECG) evidence coronary artery disease (CAD); II 212, 42.2%), ECG CAD considered stable after further evaluation studies such as dipyridamole-thallium scanning, echocardiography, arteriography; III 28, 5.6%), unstable evaluation. Group had and underwent without invasive treatment CAD. before 21) coincident 7) repair. In all instances, perioperative fluid volume management was left ventricular performance curves constructed operation. The 30-day operative rate in 500 patients 1.6% 8). There one (0.4%) cardiac-related death I, which significantly less than the five (2.4%) (p 0.02). Total two also different, seven deaths (3.3%), These data support conclusions that (1) leading cause is myocardial infarction, (2) correction severe effective preventing mortality, (3) known should be investigated more thoroughly to identify those likely develop ischemia so their can corrected repair, (4) rarely die thus selective grounds justified.