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Perioperative management and outcome of patients having cardiac surgery combined with abdominal aortic aneurysm resection.

Abstract：

:Patients with abdominal aortic aneurysms (AAA) have a high incidence of associated cardiac disease. If a patient presents with both severe coronary artery disease and a large AAA, a staged procedure of cardiac surgery (CS) followed by AAA resection may present too great a risk of aneurysm rupture and death. A combined procedure may be recommended in this circumstance; however, the literature contains only individual successful case reports of such a procedure. A series of 10 patients who underwent CS and AAA repair to define the risks and outcome of this complex patient population is presented. Methods used included a retrospective analysis of hospital chart data from patients undergoing combined CS and AAA resection from 1980 to the present at this institution. The data analyzed included age, sex, chief complaint, past medical history, indications for surgery, abdominal aneurysm size, coronary anatomy, valvular pathology, preoperative left ventricular function, anesthetic agent and dose, order of surgery, prebypass complications, intraoperative complications, cardiopulmonary bypass time, aortic cross-clamp time, abdominal aortic cross-clamp time, blood product use, and postoperative complications. Seven of the 10 patients had a successful outcome (S group), whereas 3 of the 10 patients died postoperatively (D group). The staged procedure of first performing CS and then the AAA resection has a combined operative mortality of 4%. When the nature of both lesions is severe and a combined procedure is necessary, there is an associated in-hospital mortality of approximately 30% at this institution. The S group patients had an unremarkable postoperative course with a relatively short hospital stay when compared to the staged procedure.

journal_name

J Cardiothorac Vasc Anesth

journal_title

Journal of cardiothoracic and vascular anesthesia

authors

O'Connor MS,Licina MG,Kraenzler EJ,Savage RM,Padua-Shannon N,Starr NJ

doi

10.1016/1053-0770(94)90163-5

subject

Has Abstract

pub_date

1994-10-01 00:00:00

pages

519-26

issue

eissn

1053-0770

issn

1532-8422

pii

1053-0770(94)90163-5

journal_volume

pub_type

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Perioperative management and outcome of patients having cardiac surgery combined with abdominal aortic aneurysm resection.