Cited by 187Aortic aneurysm repair treatmentsAortic Disease and Treatment ApproachesCardiac, Anesthesia and Surgical Outcomes

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Late survival after abdominal aortic aneurysm repair: Influence of coronary artery disease

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Hollier, L.H., Plate, G., O'Brien, P.C., Kazmier, F.J., Gloviczki, P., Pairolero, P.C., Cherry, K.J.·1984·Journal of Vascular Surgery

DOI 10.1016/0741-5214(84)90060-0

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Abstract

To evaluate long-term survival in relation to preoperative risk factors, we reviewed 1112 patients undergoing abdominal aortic aneurysm (AAA) repair from 1970 to 1975. A 6-to 12-year follow-up was obtained on 1087 patients (97.7%) by chart review, death certificates, autopsy reports, and questionnaires returned by patients and referring physicians. Preoperatively 24% of patients had a history of prior myocardial infarction, 19.9% had a history of angina, and 40.4% were hypertensive. Emergency operation for ruptured aneurysm was performed in 6.5% and for expanding aneurysm in 3.4% of patients. The survival rate at 5 years was 67.5% and at 10 years was 40.7%. Cardiac-related problems were the most frequent cause of death (38%); 23% died of myocardial infarction and 15% from other heart disease or sudden death. Other causes included neoplasm (14.6%), other ruptured aneurysm (8.2%), and stroke (6.8%). Cause of death was unknown in 19.6%. A significant correlation of reduced survival time was noted in patients with advanced age and those with evidence of heart disease or hypertension. For patients without preoperative evidence of heart disease or hypertension, the 5-year mortality rate from myocardial infarction was 3.7%, compared with 11.7% for those with a positive history of hypertension and heart disease (p = 0.0001). For patients with no preoperative evidence of hypertension or heart disease, the length of survival after AAA repair was the same as that expected for the general population with the same age and sex composition. This study supports the contention that coronary angiography and prophylactic coronary bypass grafting should be performed selectively. Decisions regarding the need for coronary revascularization should be based on symptoms, noninvasive testing, and selective coronary angiography because aneurysmal disease alone is not shown in this study to increase the risk of death from myocardial disease. For patients with clinical findings of coronary artery disease, an aggressive diagnostic approach appears to be justified.

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Authors: Hollier, L. H., Plate, G., O'Brien, P. C., Kazmier, F. J., Gloviczki, P., Pairolero, P. C., & Cherry, K. J.
Affiliations: Mayo Clinic (US)
ORCID: Hollier, L.H.
Gloviczki, P.
Venue: Journal of Vascular Surgery
Publisher: Elsevier BV
Published: 1984-03
Volume: 1
Issue: 2
Pages: 290-299
ISSN: 0741-5214 (ISSN-L)
DOI: 10.1016/0741-5214(84)90060-0
OpenAlex: W2064437386
Cited by: 187
References: 28
Citations by year: 2026: 1 · 2021: 1 · 2019: 2 · 2018: 1 · 2017: 1 · 2016: 3 · 2015: 5 · 2014: 4 · 2013: 1 · 2012: 3
FWCI: 7.93
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Journal of Vascular Surgery (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Surgery › Aortic aneurysm repair treatments
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Aortic Disease and Treatment Approaches
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac, Anesthesia and Surgical Outcomes
Keywords: abdominal aortic aneurysm repair, long-term survival, coronary artery disease, myocardial infarction, hypertension, preoperative risk factors, coronary angiography, coronary artery bypass grafting, coronary revascularization, causes of death, aneurysm rupture, age and mortality
MeSH terms: Aged, Angina Pectoris, Aorta, Abdominal, Aortic Aneurysm, Coronary Disease, Female, Humans, Hypertension, Male, Middle Aged, Myocardial Infarction, Risk, Rupture

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Late survival after abdominal aortic aneurysm repair: Influence of coronary artery disease

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