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Prognostic value of extended cardiac risk assessment before elective open abdominal aortic surgery.
- Source :
-
Herz [Herz] 2024 Jun; Vol. 49 (3), pp. 210-218. Date of Electronic Publication: 2023 Oct 03. - Publication Year :
- 2024
-
Abstract
- Background: Major vascular surgery is associated with a high perioperative risk and significant mortality. Despite advances in risk stratification, monitoring, and management of perioperative complications, cardiac complications are still common. Stress echocardiography is well established in coronary artery disease diagnostics; however, its prognostic value before high-risk aortic surgery is unknown. This prospective, single-center study compared the outcome of patients undergoing extended cardiac risk assessment before open abdominal aortic surgery with the outcome of patients who had received standard preoperative assessment.<br />Methods: The study included patients undergoing elective open abdominal aortic surgery. Patients who underwent standard preoperative assessment before the start of a dedicated protocol were compared with patients who had extended cardiac risk assessment, including dobutamine stress echocardiography, as part of a stepwise interdisciplinary cardiovascular team approach. The combined primary endpoint was cardiovascular death, myocardial infarction, emergency coronary revascularization, and life-threatening arrhythmia within 30 days. The secondary endpoint was acute renal failure and severe bleeding.<br />Results: In total, 77 patients (mean age 68.1 ± 8.1 years, 70% male) were included: 39 underwent standard and 38 underwent cardiac risk assessment. The combined primary endpoint was reached significantly more often in patients before than after implementation of the extended cardiac stratification procedure (15% vs. 0%, p = 0.025). The combined secondary endpoint did not differ between the groups.<br />Conclusions: Patients with extended cardiac risk assessment undergoing elective open abdominal aortic surgery had better 30-day outcomes than did those who had standard preoperative assessment.<br /> (© 2023. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)
- Subjects :
- Humans
Male
Risk Assessment
Female
Aged
Prognosis
Germany epidemiology
Survival Rate
Postoperative Complications mortality
Preoperative Care methods
Reproducibility of Results
Treatment Outcome
Vascular Surgical Procedures adverse effects
Comorbidity
Sensitivity and Specificity
Risk Factors
Prevalence
Elective Surgical Procedures mortality
Aorta, Abdominal surgery
Aorta, Abdominal diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1615-6692
- Volume :
- 49
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Herz
- Publication Type :
- Academic Journal
- Accession number :
- 37789149
- Full Text :
- https://doi.org/10.1007/s00059-023-05209-y