Preventive myocardial revascularization prior to abdominal aortic repair in patients without cardiac symptoms: long-term results

• Published in: Hirurgija (Moskva) no. 5; p. 58
• Main Authors: Chupin, A V, Abrosimov, A V, Kharazov, A F, Masalimov, N R
• Format: Journal Article
• Language: English; Russian
• Published: Russia (Federation) 2024
• Subjects: Aged; Aorta, Abdominal - diagnostic imaging; Aorta, Abdominal - surgery; Aortic Aneurysm, Abdominal - diagnosis; Aortic Aneurysm, Abdominal - surgery; Coronary Angiography - methods; Coronary Artery Disease - complications; Coronary Artery Disease - diagnosis; Coronary Artery Disease - surgery; Female; Follow-Up Studies; Humans; Long Term Adverse Effects - diagnosis; Long Term Adverse Effects - etiology; Long Term Adverse Effects - prevention & control; Male; Middle Aged; Myocardial Revascularization - adverse effects; Myocardial Revascularization - methods; Outcome and Process Assessment, Health Care; Postoperative Complications - etiology; Postoperative Complications - prevention & control; Russia - epidemiology; Vascular Surgical Procedures - adverse effects; Vascular Surgical Procedures - methods; Russia; coronary artery disease; coronary artery stenosis; cardiac risks; abdominal aortic aneurysm; coronary angiography
• ISSN: 0023-1207
• DOI: 10.17116/hirurgia202405158

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).
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 1
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 2
group, 53 patients underwent repair without invasive coronary screening, and data on 48 patients were obtained in this group.
The median follow-up was 32 and 79 months, respectively. Kaplan-Meyer overall 48-month survival was 87.3% and 82.1%, respectively (
=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 (
=0.165).
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.