Email this article Cardioprotection in abdominal aortic aneurysm surgical repair
- Authors: Vachev A.N.1, Gryaznova D.A.1, Dmitriev O.V.1, Tereshina O.V.1, Italyantcev A.Y.1, Chernovalov D.A.1, Kozin I.I.1
-
Affiliations:
- Samara State Medical University
- Issue: Vol 4, No 2 (2019)
- Pages: 66-69
- Section: Surgery
- URL: https://ogarev-online.ru/2500-1388/article/view/43785
- DOI: https://doi.org/10.35693/2500-1388-2019-4-2-66-69
- ID: 43785
Cite item
Full Text
Abstract
Objectives – to evaluate the efficacy of different types of risk reducing cardioprotection preceding the open surgery on the abdominal aorta.
Material and methods. The study analyses the treatment outcomes in 262 patients with abdominal aortic aneurysm. In all the patients the operation of prosthetics of abdominal aorta was performed. The patients were divided in two groups depending on the method of preoperative cardioprotection. The first group included 158 patients who received the intensive medicamentous preparation for the surgery. The second group of 104 patients additionally to drug treatment underwent the stress EchoCG; the coronarography was performed in patients with the positive test result. If the coronarography revealed the significant impairment of the coronary artery, the preliminary cardioprotective operations were performed: myocardial revascularization in 24 patients, CABG in 5 patients and coronary stenting in 19 cases.
Results. In spite of the intensive medicamentous preoperative preparation, in the first group the rate of myocardial infarction and acute coronary syndrome outcomes was significantly higher than in the second group of patients, who received the different preliminary myocardial revascularization according to individual requirements.
Conclusion. The individual approach to the choice of cardioprotection method before abdominal aortic aneurysm surgery significantly reduces the adverse cardiac events rate.
Full Text
##article.viewOnOriginalSite##About the authors
Aleksei N. Vachev
Samara State Medical University
Email: grjaznova_d@mail.ru
ORCID iD: 0000-0002-4925-0129
PhD, Professor, the Head of Surgery department and Faculty surgery clinics
Russian Federation, SamaraDina A. Gryaznova
Samara State Medical University
Author for correspondence.
Email: grjaznova_d@mail.ru
ORCID iD: 0000-0001-7148-2017
Сardiologist, Vascular Department №1 in Faculty surgery clinics
Russian Federation, SamaraOleg V. Dmitriev
Samara State Medical University
Email: grjaznova_d@mail.ru
ORCID iD: 0000-0003-2756-7536
PhD, Cardiovascular Surgeon, the Head of Vascular Department №1 in Faculty surgery clinics
Russian Federation, SamaraOlga V. Tereshina
Samara State Medical University
Email: grjaznova_d@mail.ru
ORCID iD: 0000-0003-0382-3363
PhD, the Head of Ultrasound diagnostic department
Russian Federation, SamaraAnton Yu. Italyantcev
Samara State Medical University
Email: grjaznova_d@mail.ru
ORCID iD: 0000-0003-0227-2635
Cardiovascular Surgeon, Vascular Department №1 in Faculty surgery clinics
Russian Federation, SamaraDenis A. Chernovalov
Samara State Medical University
Email: grjaznova_d@mail.ru
ORCID iD: 0000-0003-3997-3048
Cardiovascular Surgeon, Vascular Department №1 in Faculty surgery clinics
Russian Federation, SamaraIgor I. Kozin
Samara State Medical University
Email: grjaznova_d@mail.ru
ORCID iD: 0000-0001-9583-4013
Cardiovascular Surgeon, Vascular Department №1 in Faculty surgery clinics
Russian Federation, SamaraReferences
- Konstantinov BA, et al. [The results of operations for the staged and single-step surgical treatment of patients with ischemic heart disease, abdominal aortic aneurysms and lesions of the main arteries of the lower extremities]. Creative Cardiology. 2008;1:47-5. (In Russ.). Константинов Б.А. и др. Результаты операций при этапном и одномоментном хирургическом лечении пациентов с ишемической болезнью сердца, аневризмами брюшной аорты и поражениями магистральных артерий нижних конечностей. Креативная кардиология. 2008;1:47-55.
- Cinara IS, et al. Aorto-caval fistulas: a review of eighteen years experience. Acta Chir Belg. 2005;105:616–620.
- Moll FL, et al. Management of abdominal aortic aneurysms clinical practice guidelines of the European society for vascular surgery. Eur J Vasс Endovasc Surg. 2011;41(S1):S1–S58.
- Collin J, et al. Oxford screening programme for abdominal aortic aneurysm in men aged 65 to 74 years. Lancet. 2009;10:613–615.
- Johansen K, et al. Ruptured abdominal aortic aneurysm: the harborview experience. J Vasс Surg. 1991;13:240–245.
- Chernyavsky AM, Karpenko AA, Chernyavsky MA [Cardiac complications and their prevention in the surgery of abdominal aortic aneurysms]. Complex problems of cardiovascular diseases. 2013;4:88–93 (In Russ.). Чернявский А.М., Карпенко А.А., Чернявский М.А. Кардиальные осложнения и их профилактика в хирургии аневризм брюшной аорты. Комплексные проблемы сердечно-сосудистых заболеваний. 2013;4:88–93.
- Roberts K., et al. Hypotensive resuscitation in patients with ruptured abdominal aortic aneurysm. Eur J Vasс Endovasc Surg. 2006;31(4):339–344.
- Bockeria LA, Spiridonov AA, Buziashvili YuI, et al. [Cardiac complications in patients with atherosclerotic combined lesions of the brachiocephalic arteries and the abdominal aorta]. Bulletin A.N. Bakulev RAMN. 2005;6(1):44–53. (In Russ.). Бокерия Л.А., Спиридонов А.A., Бузиашвили Ю.И. и др. Кардиальные осложнения у больных с атеросклеротическими сочетанными поражениями брахиоцефальных артерий и брюшной аорты. Бюллетень НЦССХ им. А.Н. Бакулева РАМН. 2005;6(1):44–53.
- Lawrence PF, et al. The epidemiology of surgically repaired aneurysms in the United States. J Vasс Surg. 1999;30(4):632–640.
- Oderich GS, et al. Infected aortic aneurysms: Aggressive presentation, complicated early outcome, but durable results. J Vasс Surg. 2001;34(5):900–908.
- McFalls EO, Ward HB, Moritz TE, et al. Coronary-artery revascularization before elective major vascular surgery. N Engl J Med. 2004;351:2795–2804.
- Poldermans D, Schouten O, Vidakovic R, et al. A clinical randomized trial to evaluate the safety of a noninvasive approach in high-risk patients undergoing major vascular surgery: the DECREASE-V Pilot Study. J Am Coll Cardiol. 2007;49:1763–1769.
Supplementary files
