[The impact of cardiac status and arterial hypertension on the results of surgical treatment of patients over 70 years with abdominal aortic aneurysms].
The recent decades were marked by a noticeable growth of the number of patients over 70 years with abdominal aortic aneurysms (AAA). As a rule, in view of the high incidence of coexistent cardial pathology and arterial hypertension in patients of this age group with AAA, the risk of the forthcoming operation may be fairly high. The aim of the work was to study the effect of the initial cardial status of the patients and lesion of the target organs in arterial hypertension on the results of surgical treatment of patients over 70 years with abdominal aortic aneurysms. The study accrued 50 patients with atherosclerotic aneurysms of the abdominal aorta who underwent operation on a scheduled basis over the period 1990-2000. The patients age varied from 70 to 85 years. The mean age was 73.2-/+2.9 years. The aneurysmal diameter varied from 4 to 12 cm (mean 6.9-/+2.09 cm). Aneurysms up to 5 cm in diameter were present in 15 (25.4%) patients, those up to 7 cm in 23 (40%), and aneurysms exceeding 7 cm were identified in 21 (35.6%) patients. 43 (72.9/5%) patients were in the patient group with an asymptomatic disease course and 16 (27.1%) patients were in a group with symptomatic AAA, Coexistent CAD was discovered in 96.6% and arterial hypertension in 62.5% of patients. The mean incidence of coexistent CAD and arterial hypertension constituted 1.64-/+0.3. The initial cardial status of the patients was evaluated according to the point classification proposed by Rutherford. Lesion of the target organs was evaluated according to the WHO classification (1996). Analysis of the results obtained has demonstrated that despite the presence of CAD in the majority of patients over 70 years with AAA, its severity was equal to 0-2 points and the mean point of postoperative cardial events in these patients turned out minimal (within the range of one point). In the presence of arterial hypertension and lesion of the heart as a target organ, the risk of cardial complications was 1,5-2 times as increased depending on the severity of initial cardial pathology.
Pokrovskiĭ
A V
AV
Department of Vascular Surgery, A. V. Vishnevsky Institute of Surgery, Russian Academy of Medical Sciences, Moscow, Russia.
Dan
V N
VN
Zlatovchen
A M
AM
Il'in
S A
SA
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000601:surgery*; D001145:Arrhythmias, Cardiac / Q000453:epidemiology; D003326:Coronary Circulation / Q000502:physiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D017202:Myocardial Ischemia / Q000453:epidemiology / Q000503:physiopathology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods