Surgical Management of Abdominal Aortic Aneurysm Complicated with Ischemic Heart Disease.
10.4326/jjcvs.25.165
- VernacularTitle:虚血性心疾患を合併した腹部大動脈りゅう症例の外科治療
- Author:
Kiyoshi Inoue
;
Soichiro Kitamura
;
Kanji Kawachi
;
Tetsuji Kawata
;
Shuichi Kobayashi
;
Nobuki Tabayashi
;
Hidehito Sakaguchi
;
Yoshiro Yoshikawa
- Publication Type:Journal Article
- Keywords:
PTCA
- From:Japanese Journal of Cardiovascular Surgery
1996;25(3):165-169
- CountryJapan
- Language:Japanese
-
Abstract:
We studied the incidence of associated ischemic heart disease (IHD) among 143 consecutive patients (male 118, female 25, mean age 68.5±6.9 years) operated upon for abdominal aortic aneurysm (AAA), excluding ruptured aneurysms. The screening of IHD was routinely performed by using dipyridamole thallium scintigraphy, and when it was positive, the lesion was further confirmed by selective coronary angiography. More than 50% luminal stenosis of the major coronary arteries was judged positive for IHD. Sixty-two patients (43%) with AAA were simultaneously afflicated with IHD. We also compared the 62 AAA patients with IHD with the remaining 81 AAA patients in this series. The patients with IHD had higher incidences of risk factors such as diabetes mellitus (p=0.0031) and hyperlipidemia (p=0.0029) than those without IHD. Five patients were operated on for AAA after coronary artery bypass grafting (CABG), 11 were operated on for AAA and IHD (CABG) simultaneously, 10 were operated on after PTCA, thirty-two patients underwent elective surgery for AAA and four had emergency procedures due to impending rupture of AAA with continuous infusion of nitroglycerin with or without diltiazem. There was no significant difference in surgical mortality between AAA patients with IHD and those without IHD (3%vs2%), and no cardiac death in this series. When both AAA and IHD are severe enough to warrant surgical treatments at the earliest opportunity, we recommend concomitant operations for AAA and IHD (CABG) since these have been performed quite successfully in our series.
