title: [Perioperative mangement of surgery for abdominal aortic aneurysm associated with coronary artery disease].
abstract: BACKGROUND
  Patients undergoing abdominal aortic aneurysm (AAA) surgery are at increased risk of perioperative cardiovascular complications due to underlying coronary artery disease (CAD). We determined retrospectively the incidence of CAD and the influence of coronary revascularization and perioperative cardiovascular complications in patients for AAA surgery.
  
  
  METHODS
  Routine coronary angiography (CAG) was performed in 159 patients prior to elective AAA surgery to estimate the presence of CAD. To compare risk factors and perioperative cardiovascular complications the patients were divided at the time of CAG into three groups: previously diagnosed CAD, newly diagnosed CAD and non-CAD.
  
  
  RESULTS
  Preoperative CAG found 129 patients (81%) with CAD. Among newly diagnosed patients 82% were asymptomatic of CAD. Forty-four patients (28%) underwent coronary revascularization (17 percutaneous coronary intervention, 3 preoperative coronary artery bypass grafting, and 24 combined coronary artery bypass grafting). Perioperative cardiac complications occurred in 35 patients (22%). No significant difference was found among the three groups in the incidence of perioperative cardiovascular complications. Two patients with severe CAD not treated with coronary revascularization died of cardiac events.
  
  
  CONCLUSIONS
  Perioperative management and coronary revascularization should be carried out with more cautions in AAA patients to reduce the incidence of cardiovascular complications after AAA surgery.
authors.affiliation: Department of Anesthesia, Kumamoto Chuo Hospital, Kumamoto.
authors.forename: Kengo
authors.initials: K
authors.lastname: Maekawa
authors.forename: Tomoko
authors.initials: T
authors.lastname: Goto
authors.forename: Tomoko
authors.initials: T
authors.lastname: Baba
authors.forename: Asuka
authors.initials: A
authors.lastname: Itou
authors.forename: Atsushi
authors.initials: A
authors.lastname: Yoshitake
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D019990:Perioperative Care; D012189:Retrospective Studies