Review of coronary artery disease in patients with infrarenal abdominal aortic aneurysm.
In the process of establishing a less invasive assessment strategy for coronary artery disease (CAD) in patients with infrarenal abdominal aortic aneurysm (AAA), the incidence of CAD and the surgical and mid-term outcomes were reviewed. From January 1994 through September 2001, 94 elective surgical repairs of AAA were carried out. Preoperative coronary angiography showed 43 patients (45.7%) had CAD: 29 (67.4%) were asymptomatic, 23 had single-vessel disease (1VD), 12 had 2VD and 8 had 3VD. Of the 43 patients with CAD, 19 (44.2%) underwent coronary interventional therapy before aortic surgery (11 percutaneous transluminal coronary angioplasty (PTCA), 8 coronary artery bypass grafting). Eight asymptomatic patients underwent coronary interventional therapy. None of the patients died of cardiac causes or experienced a postoperative cardiac event. During the follow-up period, 10 late deaths occurred: 7 patients with CAD, and 3 cerebrovascular or cardiac deaths. There was no statistical difference in the survival rate between the groups with and without CAD. Two patients with CAD underwent PTCA during the follow-up period. The findings confirm the need for a less invasive assessment strategy of CAD that does not overlook asymptomatic myocardial ischemia, because the incidence of CAD in patients with AAA is high.
Kioka
Yukio
Y
Department of Cardiovascular Surgery, Fukuyama Municipal Hospital, Japan.
Tanabe
Atsusi
A
Kotani
Yasuhiro
Y
Yamada
Nobuyuki
N
Nakahama
Makoto
M
Ueda
Toshiyuki
T
Seitou
Tetsusi
T
Maruyama
Masahiko
M
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017544:Aortic Aneurysm, Abdominal / Q000150:complications* / Q000401:mortality / Q000601:surgery*; D002423:Cause of Death; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000150:complications* / Q000401:mortality / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012079:Renal Circulation