Influence of coronary artery disease and left ventricular dysfunction on postoperative mortality in vascular surgery.
In an attempt to assess the influence of coronary artery disease and left ventricular dysfunction on postoperative mortality, 107 patients consisting of 32 AAA resections and 44 aortoiliac and 31 femoropopliteal reconstructions were reviewed. All patients had a preoperative coronary angiograms and underwent cardiac catheterization to prevent cardiac-related deaths. Severe coronary artery disease was angiographically demonstrated in 40.6% of AAA, 31.8% of AI and 3.2% of FP patients. Severe left ventricular dysfunction was found in 21.9% of AAA, 18.2% of AI and 6.5% of FP. Both of the early and 5 (45.5%) of the 11 late deaths were caused by cardiac events. The nine-year survival rate (53.3%) in the patients with a documented combination of coronary artery disease and left ventricular dysfunction was significantly lower than those in patients with normal disease, normal left ventricular function and either documented coronary artery disease or left ventricular dysfunction. It is suggested from this series that left ventricular dysfunction is one of the most important risk factors in patients who undergo AAA resection and AI reconstruction and that severe disease and postoperative mortality are possibly reduced by certain kinds of interventional coronary therapies.
Nagaoka
H
H
Department of Cardiovascular and Thoracic Surgery, Tsuchiura Kyodo General Hospital, Japan.
Innami
R
R
Funakoshi
N
N
Fujiwara
A
A
Watanabe
M
M
D000206:Actuarial Analysis; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000401:mortality / Q000601:surgery*; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000401:mortality / Q000601:surgery*; D006328:Cardiac Catheterization; D017023:Coronary Angiography; D003327:Coronary Disease / Q000150:complications / Q000175:diagnosis / Q000401:mortality*; D005260:Female; D005263:Femoral Artery; D005500:Follow-Up Studies; D006769:Hospitals, General; D006801:Humans; D007083:Iliac Artery; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D015996:Survival Rate; D014656:Vascular Surgical Procedures / Q000401:mortality*; D016277:Ventricular Function, Left