PREVALENCE OF CARDIAC RISK FACTORS IN PATIENTS WITH ABDOMINAL AORTIC ANEURYSM
https://doi.org/10.21518/2307-1109-2019-1-138-147
Abstract
Introduction. According to the literature, 27 to 65 % of patients with abdominal aortic aneurysm also suffer from coronary heart disease. Mortality from coronary heart disease after surgical treatment for abdominal aortic aneurysm according to some data exceeds 20 %.
Objective: improvement of results of treatment of patients with combined lesions of coronary arteries and aneurysm of the abdominal aorta
Subjects and method. A retrospective analysis of case histories of 100 patients hospitalized in our clinic diagnosed with «abdominal aortic aneurysm» for examination. Of all patients, 37 % were diagnosed with significant coronary artery lesions. The average ejection fraction was 58.2 ± 5.4 %, 13 % of the study diagnosed significant violations of local myocardial contractility. 16 % of patients had previous myocardial infarction, 7 % – a permanent form of atrial fibrillation. 4 % of patients complained of chest pain during exercise. Hypertension was present in 100 % of patients, the average maximum systolic blood pressure was 176 ± 24.5 mmHg.
Results. Hospital mortality was 2 % (all patients were non-operated on coronary arteries and had no significant coronary pathology). There were no significant complications (cardiac, neurological, respiratory) in the early postoperative period. The average length of hospital stay was 9.8 ± 1.99 bed days.
Conclusions. Determination of cardiac status before surgery for abdominal aortic aneurysm is the most important moment of stratification of the risk of perioperative complications. Coronary angiography in patients with abdominal aortic aneurysm is a mandatory point of diagnosis, allowing to identify cardiac risk factors.
About the Authors
V. S. Arakelyan
H. M. Sovmen Modern Medical Center LLC
Russian Federation
Russian Federation
Dr. of Med. (Sci.), Professor, Head of Department
Tel.. +7 (917) 580-0808
Russia, Republic ofAdygea, aul Afipsip, Kirimize Zhane St., 5
A. R. Jane
H. M. Sovmen Modern Medical Center LLC
Russian Federation
Russian Federation
Cand. of Sci. (Med.), General Director
Russia, Republic ofAdygea, aul Afipsip, Kirimize Zhane St., 5
N. A. Gidaspov
H. M. Sovmen Modern Medical Center LLC
Russian Federation
Russian Federation
Cand. of Sci. (Med.), Researcher
Tel.: 8-977-806-6080
Russia, Republic ofAdygea, aul Afipsip, Kirimize Zhane St., 5
P. P. Kulichkov
Federal State Budgetary Institution «Bakulev National Medical Research Center of Cardiovascular Surgery» of the Ministry of Health
Russian Federation
Russian Federation
Cand. of Sci. (Med.), Researcher
Tel.: +7 (977) 806-60-80
119049, Russia, Moscow, Leninsky Prospect, 8, Bldg. 4
N. V. Bortnikova
Federal State Budgetary Institution «Bakulev National Medical Research Center of Cardiovascular Surgery» of the Ministry of Health
Russian Federation
Russian Federation
Cand. of Sci. (Med.), Junior Researcher
Tel.: +7 (916) 955-99-04
119049, Russia, Moscow, Leninsky Prospect, 8, Bldg. 4
References
1. Sprung J., Abdelmalak B., Gottlieb A. et al. Analysis of risk factors for myocardial infarction and cardiac mortality after major vascular surgery. Anesthesiology. 2000;93 (1):129–40.
2. Altobelli E., Rapacchietta L., Profeta V. F., Fagnano R. Risk Factors for Abdominal Aortic Aneurysm in Population-Based Studies: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2018 Dec 10;15 (12). pii: E2805. doi: 10.3390/ijerph15122805.
3. Han S. R., Kim Y. W., Heo S. H., Woo S. Y. et al. Frequency of concomitant ischemic heart disease and risk factor analysis for an early postoperative myocardial infarction after elective abdominal aortic aneurysm repair. Ann Surg Treat Res. 2016 Mar;90 (3):171–8. doi: 10.4174/astr.2016.90.3.171. Epub 2016 Feb 26.
4. Sprung J., Abdelmalak B., Gottlieb A. et al. Analysis of risk factors for myocardial infarction and cardiac mortality after major vascular surgery. Anesthesiology. 2000;93 (1):129–40.
5. Pecoraro F., Wilhelm M., Kaufmann A. R., Bettex D. et al. Early endovascular aneurysm repair after percutaneous coronary interventions. J Vasc Surg. 2015 May;61 (5):1146–50. doi: 10.1016/j.jvs.2014.12.044. Epub 2015 Feb 2.
6. Han S. R., Kim Y. W., Heo S. H., Woo S. Y. et al. Frequency of concomitant ischemic heart disease and risk factor analysis for an early postoperative myocardial infarction after elective abdominal aortic aneurysm repair. Ann Surg Treat Res. 2016 Mar;90 (3):171–8. doi: 10.4174/astr.2016.90.3.171. Epub 2016 Feb 26.
7. Hertzer N. R., Beven E. G., Young J. R., O’Hara P. J. et al. Coronary artery disease in peripheral vascular patients. A classification of 1000 coronary angiograms and results of surgical management. Ann Surg. 1984;199:223–233.
8. Pecoraro F., Wilhelm M., Kaufmann A. R., Bettex D. et al. Early endovascular aneurysm repair after percutaneous coronary interventions. J Vasc Surg. 2015 May;61 (5):1146–50. doi: 10.1016/j.jvs.2014.12.044. Epub 2015 Feb 2.
9. Sun T., Cheng Y. T., Zhang H. J., Chen S. H. et al. Severe coronary artery disease in Chinese patients with abdominal aortic aneurysm: prevalence and impact on operative mortality. Chin Med J (Engl). 2012;125:1030–1034.
10. Hertzer N. R., Beven E. G., Young J. R., O’Hara P. J. et al. Coronary artery disease in peripheral vascular patients. A classification of 1000 coronary angiograms and results of surgical management. Ann Surg. 1984;199:223–233.
11. Takahashi J., Okude J., Gohda T., Murakami T. et al. Coronary artery bypass surgery in patients with abdominal aortic aneurysm: detection and treatment of concomitant coronary artery disease. Ann Thorac Cardiovasc Surg. 2002;8:213–219.
12. Sun T., Cheng Y. T., Zhang H. J., Chen S. H. et al. Severe coronary artery disease in Chinese patients with abdominal aortic aneurysm: prevalence and impact on operative mortality. Chin Med J (Engl). 2012;125:1030–1034.
13. Lee S. H., Chang S. A., Jang S. Y., Lee S. C. et al. Screening for abdominal aortic aneurysm during transthoracic echocardiography in patients with significant coronary artery disease. Yonsei Med J. 2015 Jan;56 (1):38–44. doi: 10.3349/ymj.2015.56.1.38.
14. Takahashi J., Okude J., Gohda T., Murakami T. et al. Coronary artery bypass surgery in patients with abdominal aortic aneurysm: detection and treatment of concomitant coronary artery disease. Ann Thorac Cardiovasc Surg. 2002;8:213–219.
15. Elkalioubie A., Haulon S., Duhamel A., Rosa M. et al. Meta-Analysis of Abdominal Aortic Aneurysm in Patients With Coronary Artery Disease. Am J Cardiol. 2015 Nov 1;116 (9):1451–6. doi: 10.1016/j.amjcard.2015.07.074. Epub 2015 Aug 14.
16. Lee S. H., Chang S. A., Jang S. Y., Lee S. C. et al. Screening for abdominal aortic aneurysm during transthoracic echocardiography in patients with significant coronary artery disease. Yonsei Med J. 2015 Jan;56 (1):38–44. doi: 10.3349/ymj.2015.56.1.38.
17. Bown M. J., Braund P. S., Thompson J., London N. J. et al. Association between the coronary artery disease risk locus on chromosome 9p21.3 and abdominal aortic aneurysm. Circ Cardiovasc Genet. 2008 Oct;1 (1):39–42. doi: 10.1161/CIRCGENETICS.108.789727.
18. Elkalioubie A., Haulon S., Duhamel A., Rosa M. et al. Meta-Analysis of Abdominal Aortic Aneurysm in Patients With Coronary Artery Disease. Am J Cardiol. 2015 Nov 1;116 (9):1451–6. doi: 10.1016/j.amjcard.2015.07.074. Epub 2015 Aug 14.
19. Kim S. M., Cho J. Y., Kim J. H., Park K. H. et al. Successful endovascular aneurysm repair for abdominal aortic aneurysm in a patient with severe coronary artery disease undergoing off-pump coronary artery bypass grafting. Chonnam Med J. 2014 Apr;50 (1):31–6. doi: 10.4068/cmj.2014.50.1.31. Epub 2014 Apr 22.
20. Bown M. J., Braund P. S., Thompson J., London N. J. et al. Association between the coronary artery disease risk locus on chromosome 9p21.3 and abdominal aortic aneurysm. Circ Cardiovasc Genet. 2008 Oct;1 (1):39–42. doi: 10.1161/CIRCGENETICS.108.789727.
21. Tobaru S., Noguchi N., Nakamura S., Kakinohana M. A Case of Acute Pulmonary Edema after Open Abdominal Aortic Aneurysm Repair. Masui. 2016 Dec;65 (12):1240–1244.
22. Kim S. M., Cho J. Y., Kim J. H., Park K. H. et al. Successful endovascular aneurysm repair for abdominal aortic aneurysm in a patient with severe coronary artery disease undergoing off-pump coronary artery bypass grafting. Chonnam Med J. 2014 Apr;50 (1):31–6. doi: 10.4068/cmj.2014.50.1.31. Epub 2014 Apr 22.
23. Attia R. R., Murphy J. D., Snider M., Lappas D. G., Darling R. C., Lowenstein E. Myocardial ischemia due to infrarenal aortic cross-clamping during aortic surgery in patients with severe coronary artery disease. Circulation. 1976 Jun;53 (6):961–965.
24. Tobaru S., Noguchi N., Nakamura S., Kakinohana M. A Case of Acute Pulmonary Edema after Open Abdominal Aortic Aneurysm Repair. Masui. 2016 Dec;65 (12):1240–1244.
25. Sumin A. N., Korok E. V., Panfilov S. D., Evdokimov D. O. et al. Myocardial revascularization before abdominal aortic surgery in patients with ischemic heart disease. Kardiologiia. 2013;53 (4):62–8.
26. Attia R. R., Murphy J. D., Snider M., Lappas D. G., Darling R. C., Lowenstein E. Myocardial ischemia due to infrarenal aortic cross-clamping during aortic surgery in patients with severe coronary artery disease. Circulation. 1976 Jun;53 (6):961–965.
27. Williams A. M., Watson J., Mansour M. A., Sugiyama G. T. Combined Coronary Artery Bypass Grafting and Abdominal Aortic Aneurysm Repair: Presentation of 3 Cases and a Review of the Literature. Ann Vasc Surg. 2016 Jan; 30:321–30. doi: 10.1016/j.avsg.2015.06.072. Epub 2015 Aug 6.
28. Sumin A. N., Korok E. V., Panfilov S. D., Evdokimov D. O. et al. Myocardial revascularization before abdominal aortic surgery in patients with ischemic heart disease. Kardiologiia. 2013;53 (4):62–8.
29. Wolff T, Baykut D., Zerkowski H. R., Stierli P. et al. Combined abdominal aortic aneurysm repair and coronary artery bypass: presentation of 13 cases and review of the literature. Ann Vasc Surg. 2006;20:23–29.
30. Williams A. M., Watson J., Mansour M. A., Sugiyama G. T. Combined Coronary Artery Bypass Grafting and Abdominal Aortic Aneurysm Repair: Presentation of 3 Cases and a Review of the Literature. Ann Vasc Surg. 2016 Jan; 30:321–30. doi: 10.1016/j.avsg.2015.06.072. Epub 2015 Aug 6.
31. Paty P. S., Darling R. C. 3rd, Chang B. B., Lloyd W. E. et al. Repair of large abdominal aortic aneurysm should be performed early after coronary artery bypass surgery. J Vasc Surg. 2000 Feb;31 (2):253–9.
32. Wolff T, Baykut D., Zerkowski H. R., Stierli P. et al. Combined abdominal aortic aneurysm repair and coronary artery bypass: presentation of 13 cases and review of the literature. Ann Vasc Surg. 2006;20:23–29.
33. Morimoto K., Taniguchi I., Miyasaka S., Suda T. et al. Combined coronary artery bypass grafting on the beating heart and abdominal aortic aneurysm repair. Circ J. 2002;66:755–757.
34. Paty P. S., Darling R. C. 3rd, Chang B. B., Lloyd W. E. et al. Repair of large abdominal aortic aneurysm should be performed early after coronary artery bypass surgery. J Vasc Surg. 2000 Feb;31 (2):253–9.
35. Gürer O., Haberal I., Ozsoy D. Combined transdiaphragmatic off-pump and minimally invasive coronary artery bypass with right gastroepiploic artery and abdominal aortic aneurysm repair. Am J Case Rep. 2013 Aug 28;14:333–6. doi: 10.12659/AJCR.889317.eCollection 2013.
36. Morimoto K., Taniguchi I., Miyasaka S., Suda T. et al. Combined coronary artery bypass grafting on the beating heart and abdominal aortic aneurysm repair. Circ J. 2002;66:755–757.
37. Gürer O., Haberal I., Ozsoy D. Combined transdiaphragmatic off-pump and minimally invasive coronary artery bypass with right gastroepiploic artery and abdominal aortic aneurysm repair. Am J Case Rep. 2013 Aug 28;14:333–6. doi: 10.12659/AJCR.889317.eCollection 2013.
Review
For citations:
Arakelyan V.S., Jane A.R., Gidaspov N.A., Kulichkov P.P., Bortnikova N.V. PREVALENCE OF CARDIAC RISK FACTORS IN PATIENTS WITH ABDOMINAL AORTIC ANEURYSM. Aterotromboz = Atherothrombosis. 2019;(1):138-147. (In Russ.) https://doi.org/10.21518/2307-1109-2019-1-138-147
Views:
1067
This work is licensed under a Creative Commons Attribution Attribution-NonCommercial-NoDerivs License.
Email this article 