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A Comparison of Cardiac Morbidity and Mortality

Christian de Virgilio, MD; Hao Bui, MD; Carlos Donayre, MD; Linda Ephraim, RN, BSN; Roger J. Lewis, MD, PhD; Magdi Elbassir, MD; Bruce E. Stabile, MD; Rodney White, MD

Arch Surg. 1999;134:947-951.

Hypothesis  Adverse cardiac event rates following endovascular abdominal aortic aneurysm (EAAA) and open abdominal aortic aneurysm (OAAA) repair are similar. We also hypothesized that the Eagle criteria (Q wave on electrocardiogram, diabetes, angina, congestive heart failure, age >70 years, and ventricular ectopy) are useful predictors of cardiac events in patients undergoing EAAA repair.

Design  Prospective (patients undergoing EAAA repair) and retrospective (patients undergoing OAAA repair).

Setting  Public teaching and Veterans Affairs medical centers.

Patients  Eighty-three EAAA and 63 OAAA repairs.

Main Outcome Measures  Myocardial infarction, congestive heart failure, and cardiac death.

Results  Patients with EAAA were older (73 vs 68 years, P=.003). There were no differences in the mean number of Eagle criteria (1.2 vs 1.3), cardiac event rates (6% vs 4.8%), or mortalities (3.6% vs 4.8%). Within the EAAA group, congestive heart failure (P=.005) and Q wave on electrocardiogram (P=.006) were the only predictors of cardiac events.

Conclusions  Patients undergoing OAAA and EAAA repair had similar cardiac event rates and mortality. In patients undergoing EAAA repair, history of congestive heart failure and Q wave on electrocardiogram were predictors of cardiac events.

From the Departments of Surgery (Drs de Virgilio, Bui, Donayre, Elbassir, Stabile, and White and Ms Ephraim) and Emergency Medicine (Dr Lewis), Harbor-UCLA Medical Center, Torrance, Calif; and the Department of Surgery, West Los Angeles Veteran Affairs Medical Center (Dr de Virgilio), Los Angeles, Calif.

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