TITLE:
Preoperative echocardiographic predictors for 1-year mortality in patients treated with standard endovascular aneurysm repair for abdominal aortic aneurysm
AUTHORS:
Tomas Ohrlander, Magnus Dencker, Stefan Acosta
KEYWORDS:
Echocardiography; EVAR; Abdominal Aortic Aneurysm; Valve Disease; Aortic Valve Stenosis
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.3 No.3,
June
4,
2013
ABSTRACT:
Background: Abdominal aortic aneurysm (AAA) and
cardiovascular disease are intimately associated, the latter representing the
most common cause of death in Sweden.
Cardiac complications are held responsible for the majority of perioperative
morbidity and mortality in patients undergoing repair of AAA. The importance of
preoperative thorough cardiac assessment is therefore obvious. The aim of
this study was to evaluate the prognostic significance of preoperative
echocardiographic findings for 1-year mortality after elective endovascular
aneurysm repair (EVAR) of infrarenal AAA. Design: Retrospective analysis. Methods:
The 505 patients were identified in a prospective database for endovascular
interventions between 1998 and 2011, and data were retrieved from patient
records. Preoperative echocardiography reports in 380 patients were reviewed
and findings were notified according to a predefined protocol. Results: The 1-year
mortality rate was 6.7%. Severe valve disease was present in 8.7% of the
patients, aortic valve stenosis being the leading cause of valve pathology.
Severe valve disease (OR 3.5, 95% CI [1.2 - 10.7]; p = 0.025) and chronic
kidney disease grade ≥ 3 (OR 7.5, 95% CI [2.1 - 26.1]; p = 0.002) were the only
independent risk factors for increased mortality rate at 1-year. Conclusion:
Echocardiography should be a part of the preoperative workup in AAA patients.
Finding of severe valve disease should be further evaluated by a cardiologist
prior to EVAR.