Cardiac response and complications during endovascular repair of abdominal aortic aneurysms: A concurrent comparison with open surgery

Cuypers, Philippe W.M.; Gardien, Martin; Buth, Jacob; Charbon, J. A.; Peels, Cathinka H.; Hop, Wim C. J.; Laheij, R.J.F.

doi:10.1067/mva.2001.103970

Cited by 42 publications

(21 citation statements)

References 31 publications

(43 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…7 Although the heterogeneity associated with blood transfusion as a risk factor is large within this metaanalysis, the signal that perioperative blood transfusion is strongly associated with adverse perioperative cardiac outcomes is consistent. This is in keeping with other studies that suggest that surgery complexity 6 7 and the extent of the surgical insult 1,6,7,9,14,16,20 are strong modifiers of perioperative cardiac risk.…”

Section: Discussionsupporting

confidence: 91%

A meta-analysis of intraoperative factors associated with postoperative cardiac complications

Skinner

Goga

Rodseth

et al. 2012

Southern African Journal of Anaesthesia and Analgesia

View full text Add to dashboard Cite

Original Research: A meta-analysis of intraoperative factors associated with postoperative cardiac complications 186 2012;18(4) South Afr J Anaesth Analg IntroductionA recent study has shown that 5% of patients who undergo noncardiac surgery will suffer a perioperative myocardial infarction. 1 More than 11% of these patients will die within 30 days of the surgery. Preoperative cardiac risk is commonly determined with the help of risk scores and risk stratification tools, such as the Revised Cardiac Risk Index (RCRI). [2][3][4][5] These scores are of limited utility as intraoperative events that relate to the surgery itself profoundly alter this calculated cardiac risk. 6,7 If these events could be identified and their impact quantified, then surgeons and anaesthetists might be able to intervene to improve perioperative cardiac outcomes.The aim of this meta-analysis was to identify intraoperative factors that changed a patient's preoperative cardiac risk of postoperative cardiac complications. MethodA meta-analysis was conducted to identify modifiable independent intraoperative predictors of postoperative cardiac complications in studies that controlled for preoperative cardiac risk factors. The Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines were adhered to in conducting and reporting this meta-analysis. AbstractBackground: Preoperative cardiac risk is commonly determined with the help of risk scores and risk stratification tools. This predetermined cardiac risk may be profoundly changed by intraoperative surgical events. This meta-analysis aimed to identify intraoperative factors that independently predict postoperative cardiac complications in the presence of preoperative cardiac risk factors.Method: A PubMed Central search was conducted from January 1966 to June 2010, to identify independent intraoperative predictors of postoperative cardiac complications in observational perioperative studies and randomised controlled trials which controlled for preoperative cardiac risk factors.Results: Eleven studies were identified for inclusion in this meta-analysis. Intraoperative blood transfusion [odds ratio (OR) 2.6, 95% confidence interval (CI) 1.8-3.4] was the only independent intraoperative risk predictor identified in more than one study. Other identified independent intraoperative factors included a > 20 mmHg fall in mean arterial blood pressure for > 60 minutes (OR 3.0, 95% CI 1.8-4.9), > 30% increase in baseline systolic pressure (OR 8.0,, tachycardia in the recovery room (> 30 beats per minute from baseline for > 5 minutes) (OR 7, 95% 1.9-26), new onset atrial fibrillation (OR 6.6, 95% CI 2.5-20), hypothermia (OR 2.2, 95% CI 1.1-5) and remote ischaemic preconditioning (OR 0.22, 95% CI 0.07-0.67). None of these studies controlled for blood transfusion.Conclusion: Both surgical and haemodynamic intraoperative events significantly increased the risk of postoperative cardiac complications. Intraoperative blood transfusion has the strongest evidence that supports this finding. It is poss...

show abstract

Section: Discussionsupporting

confidence: 91%

A meta-analysis of intraoperative factors associated with postoperative cardiac complications

Skinner

Goga

Rodseth

et al. 2012

Southern African Journal of Anaesthesia and Analgesia

View full text Add to dashboard Cite

show abstract

“…More than half of all type II endoleaks will seal spontaneously, however, and although isolated examples of aneurysm rupture on the basis of persistent type II endoleaks have been reported (1145,1146), they do not yet appear to influence the risk for rupture during 18 to 36 months of surveillance in large series of patients (1147,1148). If an intervention is necessary for the few type II endoleaks that persist or are associated with e590 by guest on May 9, 2018 http://circ.ahajournals.org/ Downloaded from ACC/AHA Practice Guidelines ACC -www.acc.org AHA -www.americanheart.org higher intraoperative cardiac index (p less than 0.01) and a lower intraoperative stroke work index (p equals 0.04) than open procedures (1162). Although the number of adverse cardiac events was comparable, postoperative electrocardiograms and transesophageal echocardiograms revealed significantly more evidence of myocardial ischemia after open operations (57% vs. 33% after endograft repair; p equals 0.01).…”

Section: Introductionmentioning

confidence: 99%

ACC/AHA 2005 Practice Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic)

Hirsch

Haskal²,

Hertzer³

et al. 2006

Circulation

2,960

1,111

View full text Add to dashboard Cite

“…However, in our patient at high risk of a cardiac event, it proved extremely useful, because she had major comorbidity, which we thought precluded open repair. Cuypers et al 9 concluded that hemodynamic changes during stent-graft repair were not as severe as those that occurred during open surgery, and resulted in less myocardial stress. We also think that stent-graft repair is Wolf et al 10 and Meguid et al 11 described performing simultaneous stent-graft repair of concomitant TAA and AAA.…”

Section: Discussionmentioning

confidence: 97%

Simultaneous Open and Endoluminal Repair of Ruptured Abdominal and Thoracic Aortic Aneurysms: Report of a Case

et al. 2004

View full text Add to dashboard Cite

A 66-year-old woman was transferred to our hospital for emergency treatment of a ruptured abdominal aortic aneurysm (AAA) and impending rupture of a descending thoracic aortic aneurysm (TAA) caused by a Stanford type-B dissection. She had severe coronary artery disease and a highly calcified aorta, and had been taking long-term steroids for rheumatoid arthritis. Endovascular repair of the TAA failed because the femoral artery was too small, so we performed simultaneous repair of the TAA and the AAA. A temporary axillofemoral bypass was constructed and the AAA was replaced with a bifurcated prosthetic graft. A thoracic stent graft was delivered successfully through a chimney graft of the abdominal graft. About 4 months later, the TAA extended proximally, causing hemoptysis, which was stopped by placing a new stent graft proximal to the previous one. This case report shows that a combination of open and endovascular repair is useful for treating a TAA with an AAA, especially in a small or frail patient.

show abstract

Cardiac response and complications during endovascular repair of abdominal aortic aneurysms: A concurrent comparison with open surgery

Cited by 42 publications

References 31 publications

A meta-analysis of intraoperative factors associated with postoperative cardiac complications

A meta-analysis of intraoperative factors associated with postoperative cardiac complications

ACC/AHA 2005 Practice Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic)

Simultaneous Open and Endoluminal Repair of Ruptured Abdominal and Thoracic Aortic Aneurysms: Report of a Case

Contact Info

Product

Resources

About