Vega de Céniga M, Estallo L, Barba A, de la Fuente N, Viviens B, Gómez R. Long-term cardiovascular outcome after elective abdominal aortic aneurysm open repair.
Ann Vasc Surg 2010;
24:655-62. [PMID:
20363099 DOI:
10.1016/j.avsg.2010.01.003]
[Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2009] [Revised: 12/03/2009] [Accepted: 01/11/2010] [Indexed: 11/25/2022]
Abstract
BACKGROUND
We analyzed the incidence of late cardiovascular events and mortality after elective infra-/juxtarenal abdominal aortic aneurysm open repair (AAA-OR).
METHODS
We included patients who survived AAA-OR in our center in 1988-2006. We registered late cardiac, cerebrovascular, and peripheral vascular events, as well as all-cause and cardiovascular mortality. We calculated patient survival and freedom from cardiovascular events (Kaplan-Meier) and evaluated risk factors (multivariate analysis).
RESULTS
We studied 297 patients: 292 (98.3%) men, aged 67 +/- 7 (44-83) years, 143 (48.1%) bifurcated grafts. In a mean follow-up of 78.7 +/- 52.9 months, we registered 203 cardiovascular events in 123 (41.4%) patients, at a rate of 0.16 cardiovascular events/patient-year. Eleven (3.7%) patients suffered graft-related complications. Freedom from cardiovascular events was 94.2%, 67.2%, 45.7%, and 27.6% at 1, 5, 10, and 15 years, respectively. Survival was 96.6%, 74.7%, 50.7%, and 31.5%, respectively. The main cause of death was cardiovascular disease (n = 54, 18.2%), followed by cancer (n = 43, 14.5%). Only four (1.3%) deaths were graft-related. Coronary artery disease and chronic renal failure were predictive of cardiovascular mortality (p = 0.033 and 0.006).
CONCLUSION
Although long-term survival is similar to that in the general population, successful AAA-OR patients remain at increased risk of cardiovascular events throughout their lifetime. Graft-related complications are rare, confirming the durability of the procedure.
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