Key result
Routine preoperative coronary angiography and preventive myocardial revascularization do not improve postoperative outcomes but may offer advantages in the long-term period.
Why the study?
Preoperative stress testing can have contraindications or errors, and while some suggest invasive coronary angiography to guide preventive revascularization in abdominal aortic aneurysm repair, its post-operative and long-term benefits remain debated.
Does routine preoperative invasive coronary angiography and preventive myocardial revascularization improve postoperative and long-term outcomes in patients with abdominal aortic aneurysms?
Does routine preoperative invasive coronary angiography and preventive myocardial revascularization improve postoperative and long-term outcomes in patients with abdominal aortic aneurysms?
Answers are grounded in this paper and cite their sources.
Routine preoperative invasive coronary angiography before abdominal aortic aneurysm repair does not improve short-term postoperative outcomes but may provide long-term benefits.
Cardiac complications are the main cause of mortality after abdominal aortic aneurysm repair. Aortic cross-clamping and blood flow release, as well as blood loss lead to functional overload of the myocardium and can provoke ischemia even in previously asymptomatic patients. Modern guidelines recommend preoperative non-invasive assessment of cardiac status. Stress tests are impossible in some cases due to certain contraindications and potential errors. Some authors suggest invasive coronary angiography to assess coronary arteries prior to surgery. The objective of this approach is to identify and correct coronary stenoses for prevention of intraoperative ischemic events. According to several studies, these measures do not improve postoperative outcomes. However, there is evidence of advantages of this approach regarding long-term period. This review is devoted to routine preoperative coronary angiography and preventive myocardial revascularization in patients with abdominal aortic aneurysms.
No takes yet. Share an insight, caveat, or question.
Abrosimov et al. (2023) conducted a review in Abdominal aortic aneurysms. Routine preoperative coronary angiography and preventive myocardial revascularization was evaluated. Routine preoperative coronary angiography and preventive myocardial revascularization do not improve postoperative outcomes but may offer advantages in the long-term period.
Synapse has enriched 10 related papers. Consider them for comparative context: