Application of clinically valid cardiac risk factors to aortic aneurysm surgery
R. A. Yeager, R. M. Weigel, E. S. Murphy, D. B. McConnell, T. M. Sasaki and R. M. Vetto
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.
