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Khirurgiia (Mosk) ; (5): 58-64, 2024.
Article in Russian | MEDLINE | ID: mdl-38785240

ABSTRACT

OBJECTIVE: To evaluate the long-term influence of preoperative invasive coronary screening and preventive myocardial revascularization on mortality and cardiac complications after open surgery for abdominal aortic aneurysms (AAA). MATERIAL AND METHODS: We present long-term outcomes after open surgery for AAA between 2011 and 2022. Patients without clinical or objective signs of coronary artery disease were included. In the 1st group, routine coronary angiography was performed before surgery. Prophylactic myocardial revascularization was performed in 12 cases. Long-term data on 45 patients were obtained. In the 2nd group, 53 patients underwent repair without invasive coronary screening, and data on 48 patients were obtained in this group. RESULTS: The median follow-up was 32 and 79 months, respectively. Kaplan-Meyer overall 48-month survival was 87.3% and 82.1%, respectively (p=0.278). In the first group, 2 patients developed angina pectoris in the same period. In the second group, we observed 2 cases of myocardial infarction and 3 cases of angina pectoris without infarction. Analysis of survival curves found no significant differences (p=0.165). CONCLUSION: In our study, invasive coronary screening and preventive myocardial revascularization in patients without clinical and objective signs of coronary artery did not improve 4-year long-term period after abdominal aortic repair. Perhaps, differences will appear after 4 years, and this requires further follow-up after coronary angiography. However, there is a tendency towards more common onsets of coronary artery disease that dictates the need for cardiac monitoring of such patients.


Subject(s)
Aortic Aneurysm, Abdominal , Coronary Angiography , Myocardial Revascularization , Postoperative Complications , Humans , Aortic Aneurysm, Abdominal/surgery , Aortic Aneurysm, Abdominal/diagnosis , Male , Female , Aged , Myocardial Revascularization/methods , Myocardial Revascularization/adverse effects , Middle Aged , Postoperative Complications/prevention & control , Postoperative Complications/etiology , Coronary Angiography/methods , Coronary Artery Disease/surgery , Coronary Artery Disease/diagnosis , Coronary Artery Disease/complications , Russia/epidemiology , Vascular Surgical Procedures/methods , Vascular Surgical Procedures/adverse effects , Aorta, Abdominal/surgery , Aorta, Abdominal/diagnostic imaging , Long Term Adverse Effects/etiology , Long Term Adverse Effects/prevention & control , Long Term Adverse Effects/diagnosis , Follow-Up Studies , Outcome and Process Assessment, Health Care
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