Young J R, Hertzer N R, Beven E G, Ruschhaupt W F, Graor R A, O'Hara P J, De Wolfe V G, Kramer J R, Simpfendorfer C C
Department of Peripheral Vascular Disease, Cleveland Clinic Foundation, Ohio 44106.
Ann Vasc Surg. 1986 May;1(1):36-42. doi: 10.1016/S0890-5096(06)60700-0.
In an attempt to reduce early and late mortality caused by myocardial infarction in patients with aortic aneurysms, coronary arteriography and, when indicated, myocardial revascularization were performed prior to elective aortic reconstruction in 302 patients with infrarenal (289) or thoracoabdominal (13) aortic aneurysms. Severe correctable coronary artery disease (CAD) was identified in 31% of the entire series, whereas severe inoperable CAD was seen in another 5%. Severe, correctable CAD was documented in 42% of patients suspected to have CAD by standard clinical criteria and in 19% of those in whom CAD was not suspected. The overall mortality for 89 cardiac and 227 infrarenal aortic surgical procedures was 4,4%. Fatal complications after infrarenal aneurysm resection occurred in only one (1.6%) of 61 patients who had had preliminary myocardial revascularization.
为降低主动脉瘤患者因心肌梗死导致的早期和晚期死亡率，对302例肾下型（289例）或胸腹型（13例）主动脉瘤患者在择期主动脉重建术前进行了冠状动脉造影，并在必要时进行了心肌血运重建。在整个系列中，31%的患者被发现患有严重的可纠正冠状动脉疾病（CAD），另有5%的患者患有严重的不可手术CAD。根据标准临床标准怀疑患有CAD的患者中，42%记录有严重的可纠正CAD，而未怀疑患有CAD的患者中这一比例为19%。89例心脏手术和227例肾下主动脉手术的总死亡率为4.4%。在61例曾进行过初步心肌血运重建的患者中，只有1例（1.6%）在肾下动脉瘤切除术后发生致命并发症。
