A single centre experience of simultaneous open abdominal aortic aneurysm and cardiac surgery☆

Kordowicz, Andrew; Ghosh, Jonathan; Baguneid, Mohamed

doi:10.1510/icvts.2009.219105

Cited by 11 publications

(8 citation statements)

References 15 publications

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“…In summary, a recommendation for percutaneous or surgical intervention for coronary artery disease should follow established clinical practice guidelines, regardless of the need for aneurysm repair. 91 Whereas simultaneous open aneurysm repair and coronary artery bypass grafting has been reported for select symptomatic patients with critical coronary artery disease, [99][100][101][102] if it is anatomically feasible, EVAR under local anesthesia would be a preferred option.…”

Section: Level Of Recommendation 1 (Strong)mentioning

confidence: 99%

The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm

Chaikof

Dalman

Eskandari

et al. 2018

Journal of Vascular Surgery

1,982

1,478

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Important new recommendations are provided for the care of patients with an AAA, including suggestions to improve mutual decision-making between the treating physician and the patients and their families as well as a number of new strategies to enhance perioperative outcomes for patients undergoing elective and emergent repair. Areas of uncertainty are highlighted that would benefit from further investigation in addition to existing limitations in diagnostic tests, pharmacologic agents, intraoperative tools, and devices.

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Section: Level Of Recommendation 1 (Strong)mentioning

confidence: 99%

The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm

Chaikof

Dalman

Eskandari

et al. 2018

Journal of Vascular Surgery

1,982

1,478

View full text Add to dashboard Cite

show abstract

“…A detailed description of the procedures, as well as the complications reported in the 12 studies, [8][9][10][11][12][13][14][15][16][17][18][19] included in our review appear in Tables 2 to 4. In total, there were 20 deaths within 30 days from both interventions accounting for a 30-day mortality rate of 7.8%.…”

Section: Resultsmentioning

confidence: 99%

Combined Coronary Artery Bypass Grafting and Open Abdominal Aortic Aneurysm Repair Is a Reasonable Treatment Approach

et al. 2013

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We reviewed the literature for studies investigating the outcomes of combined 1-stage coronary artery bypass grafting (CABG) and abdominal aortic aneurysm (AAA) open repair (OR) procedures. An electronic search of the English literature was conducted using the PubMed, EMBASE, and Cochrane databases. Age, coronary heart disease severity, AAA size, mean duration from CABG to AAA OR procedures, details of each procedure, mortality, and morbidity rates were analyzed. Between 1994 and 2012, 12 studies (256 patients) with 1-stage treatment fulfilled the inclusion criteria and were analyzed. There were 20 early (30 days) deaths, accounting for a 30-day mortality rate of 7.8%. The early morbidity was 53% (136 of 256). One-stage treatment when necessary can be undertaken with acceptable mortality and reasonable morbidity rates considering the complexity of both the operations. Nowadays, endovascular AAA repair is preferred over OR. The outcomes of combined cardiac surgery and endovascular AAA repair have not been extensively evaluated.

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“…Also, Hosokawa et al [15] show that in patients undergoing AAA open repair and coronary artery intervention, the cardiac eventfree rate was comparable with that of other groups, although mortality was higher. On the other hand, Kordowicz et al [29] conclude that simultaneous open repair of AAA and cardiac surgery is a feasible option for patients with CAD. Similar conclusions were reached by Sumin et al [20], where CAG and preventive revascularization before AAA surgery were associated with less perioperative complications, MIs, and lower mortality.…”

Section: Discussionmentioning

confidence: 99%

Coexistence and management of abdominal aortic aneurysm and coronary artery disease

et al. 2020

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Background: Abdominal aortic aneurysm (AAA) and coronary atherosclerosis share common risk factors. In this study, a single-center management experience of patients with a coexistence of AAA and coronary artery disease (CAD) is presented. Methods: 271 consecutive patients who underwent elective AAA repair were reviewed. Coronary imaging in 118 patients was considered suitable for exploration of AAA coexistence with CAD. Results: Significant coronary stenosis (> 70%) were found in 65.3% of patients. History of cardiac revascularization was present in 26.3% of patients, myocardial infarction (MI) in 31.4%, and 39.8% had both. In a subgroup analysis, prior history of percutaneous coronary intervention (PCI) (OR = 6.9, 95% CI 2.6-18.2, p < 0.001) and patients' age (OR = 1.1, 95% CI 1.0-1.2, p = 0.007) were independent predictors of significant coronary stenosis. Only 52.0% (40/77) of patients with significant coronary stenosis underwent immediate coronary revascularization prior to aneurysm repair: PCI in 32 cases (4 drug-eluting stents and 27 bare metal stents), coronary artery bypass graft in 8 cases. Patients undergoing revascularization prior to surgery had longer mean time from coronary imaging to AAA repair (123.6 vs. 58.1 days, p < 0.001). Patients undergoing coronary artery evaluation prior to AAA repair had shorter median hospitalization (7 [2-70] vs. 7 [3-181] days, p = 0.007) and intensive care unit stay (1 [0-9] vs. 1 [0-70] days, p = 0.014) and also had a lower rate of major adverse cardiovascular events or multiple organ failure (0% vs. 3.9%, p = 0.035). A total of 11.0% of patients had coronary artery aneurysms. Conclusions: Patients with AAA might benefit from an early coronary artery evaluation strategy.

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A single centre experience of simultaneous open abdominal aortic aneurysm and cardiac surgery☆

Abstract: Simultaneous open repair of AAA and cardiac surgery is a feasible option for this high-risk and anatomically challenging patient group. This experience highlights the need for close cooperation between vascular and cardiac teams.

Cited by 11 publications

References 15 publications

The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm

The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm

Combined Coronary Artery Bypass Grafting and Open Abdominal Aortic Aneurysm Repair Is a Reasonable Treatment Approach

Coexistence and management of abdominal aortic aneurysm and coronary artery disease

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