Influence of coronary artery disease on operative mortality and long-term survival after abdominal aortic aneurysm repair.
OBJECTIVE
This retrospective study was conducted to evaluate the effects of coronary artery disease (CAD) on short- and long-term survival after abdominal aortic aneurysm (AAA) repair.


METHODS
One hundred consecutive patients underwent elective AAA repair between 1991 and 2002. Coronary angiography was performed in all patients, revealing significant coronary artery lesions in 47 (47%). Percutaneous transluminal coronary angioplasty (PTCA) was performed in 11 patients, 20 (median) days before the abdominal surgery. Abdominal aortic aneurysm repair was performed 60 (median) days after coronary artery bypass grafting (CABG) in five patients, and both procedures were performed simultaneously in two patients.


RESULTS
The in-hospital mortality rate for AAA repair was 1.0%, but there was no cardiac-related operative morbidity or mortality. The 96 patients discharged were followed up for a mean period of 2.9 years (range 3-143 months). The cumulative survival rates after 1, 2, 3, and 5 years were 98%, 95%, 88%, and 77%, respectively. Only one patient (1%) died of myocardial infarction. There was no significant difference in the long-term survival of the CAD and non-CAD patients.


CONCLUSIONS
These results emphasize the importance of routine coronary angiography and subsequent coronary revascularization to improve early and late survival rates after AAA repair.
Sasaki
Yasuyuki
Y
Department of Cardiovascular Surgery, Osaka National Hospital, Osaka, Japan.
Isobe
Fumitaka
F
Kinugasa
Seiji
S
Iwata
Keiji
K
Murakami
Tadahiro
T
Saito
Motoko
M
Motoki
Manabu
M
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017544:Aortic Aneurysm, Abdominal / Q000453:epidemiology* / Q000401:mortality*; D015897:Comorbidity; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies