Trends in cardiac morbidity and mortality after endoluminal abdominal aortic aneurysm repair; discussion 999-1000.
OBJECTIVE
The adverse cardiac event rate following endoluminal abdominal aortic aneurysm (EAAA) repair has decreased as experience in performing the procedure has increased. Aneurysm complexity affects the rate of adverse cardiac events.


METHODS
Data from 173 consecutive patients undergoing EAAA repair from 2 successive periods were compared. There were 82 patients in the early group (group 1) and 91 patients in the later group (group 2).


METHODS
Myocardial infarction, congestive heart failure, unstable angina, major dysrhythmias, death.


RESULTS
The cardiac event rate was 8.5% for group 1 vs 16.5% for group 2 (P =.16). Predictors of adverse cardiac events on multivariate analysis were the use of 4 or more graft extensions (P =.04), female sex (P =.01), and number of Eagle risk factors (P<.001). There were 2 postoperative deaths (2.4%) in group 1 and 4 (4.4%) in group 2 (P =.7).


CONCLUSIONS
Following EAAA repair: (1) adverse cardiac events were found to correlate with use of 4 or more graft extensions, female sex, and the number of Eagle risk factors; (2) cardiac morbidity and mortality remain significant despite greater experience and improved technology; and (3) operative mortality remains acceptably low.
Romero
L
L
Harbor-UCLA Medical Center, Department of Surgery, 1000 W Carson St, Torrance, CA 90509, USA.
de Virgilio
C
C
Donayre
C
C
Stabile
B E
BE
Lewis
R J
RJ
Narahara
K
K
Lippmann
M
M
White
R
R
Chang
C
C
D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty / Q000009:adverse effects*; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D001145:Arrhythmias, Cardiac / Q000209:etiology / Q000401:mortality; D019917:Blood Vessel Prosthesis Implantation; D017558:Elective Surgical Procedures; D005260:Female; D006331:Heart Diseases / Q000209:etiology* / Q000401:mortality; D006333:Heart Failure / Q000209:etiology / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000209:etiology / Q000401:mortality; D016017:Odds Ratio; D011183:Postoperative Complications; D012307:Risk Factors; D015607:Stents