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Lina Romero, MD; Christian de Virgilio, MD; Carlos Donayre, MD; Bruce E. Stabile, MD; Roger J. Lewis, MD,PhD; Kenneth Narahara, MD; Maurice Lippmann, MD; Rodney White, MD; Catherine Chang, MD

Arch Surg. 2001;136:996-1000.

Hypothesis  The adverse cardiac event rate following endoluminal abdominal aortic aneurysm (EAAA) repair has decreased as experience in performing the procedure has increased. Aneurysm complexity affects the rate of adverse cardiac events.

Design and Patients  Data from 173 consecutive patients undergoing EAAA repair from 2 successive periods were compared. There were 82 patients in the early group (group 1) and 91 patients in the later group (group 2).

Main Outcome Measures  Myocardial infarction, congestive heart failure, unstable angina, major dysrhythmias, death.

Results  The cardiac event rate was 8.5% for group 1 vs 16.5% for group 2 (P = .16). Predictors of adverse cardiac events on multivariate analysis were the use of 4 or more graft extensions (P = .04), female sex (P = .01), and number of Eagle risk factors (P<.001). There were 2 postoperative deaths (2.4%) in group 1 and 4 (4.4%) in group 2 (P = .7).

Conclusions  Following EAAA repair: (1) adverse cardiac events were found to correlate with use of 4 or more graft extensions, female sex, and the number of Eagle risk factors; (2) cardiac morbidity and mortality remain significant despite greater experience and improved technology; and (3) operative mortality remains acceptably low.

From the Departments of Surgery (Drs Romero, de Virgilio, Donayre, Stabile, White, and Chang) and Internal Medicine, Division of Cardiology (Dr Narahara), Anesthesiology (Dr Lippmann), and Emergency Medicine (Dr Lewis), Harbor-UCLA Medical Center, Torrance, Calif.

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