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Richard A. Yeager, MD; Ronald M. Weigel, PhD; Edward S. Murphy, MD; Donald B. McConnell, MD; Truman M. Sasaki, MD; R. Mark Vetto, MD

Arch Surg. 1986;121(3):278-281.

Abstract
• The operative outcome of 97 consecutive nonruptured infrarenal aortic aneurysms is analyzed regarding clinically identifiable cardiac risk factors. Clinically evident coronary artery disease was present in 45 patients (46%). Operative mortality was 4% (four cardiac deaths) with an additional 4% nonfatal postoperative myocardial infarction rate. All cardiac complications occurred in patients with clinically evident coronary artery disease, while no mortality occurred in 52 patients lacking a preoperative history of myocardial infarction, congestive heart failure, or angina. Preoperative risk factors having a significant negative influence on outcome include a history of prior myocardial infarction and compensated congestive heart failure. Few patients with aneurysms who have clinical evidence of coronary artery disease are indicated for coronary arteriography and bypass prior to aneurysm repair. Furthermore, indications for invasive cardiac screening of the patient with an aneurysm who lacks cardiac symptoms are limited.

(Arch Surg 1986;121:278-281)

Author Affiliations
From the Departments of Surgery (Drs Yeager, McConnell, Sasaki, and Vetto), Cardiology (Dr Murphy), Research (Dr Wiegel), and Medical Psychology (Dr Wiegel), Portland (Ore) Veterans Administration Medical Center, and the Oregon Health Sciences University, Portland.

Footnotes
Accepted for publication Nov 26, 1985.

Read before the Ninth Annual Surgical Symposium of the Association of Veterans Administration Surgeons, Tampa, Fla, May 8, 1985.

Reprint requests to Surgical Services (112P), Portland Veterans Administration Medical Center, PO Box 1034, 3710 SW US Veterans Hospital Rd, Portland, OR 97207 (Dr Yeager).

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