Outcomes after open repair of aortic aneurysms and dissections in cannabis consumers.

OBJECTIVE

To investigate the influence of cannabis consumption on the mid- and long-term surgical outcomes of patients with aortic aneurysms or dissections.

METHODS

All individuals aged 18 years and older with more than 6 months of cannabis use at the time of surgical repair for cardiovascular disease (aortic aneurysms or aortic dissection) between 2007 and 2023 were eligible. Patients were stratified into 2 groups based on their preoperative history of cannabis use: cannabis users and noncannabis users. The primary end point was complications or death within 30 days of intervention. Secondary outcomes included late complications and reinterventions. Data were combined from our institution and inpatient hospital records.

RESULTS

We identified 134 patients who met the inclusion criteria out of 1543 treated patients (9%). Compared with the nonusing cannabis group, individuals in the cannabis group were significantly younger (cannabis: 48.3 ± 11.8 years vs noncannabis: 58.5 ± 14.9 years;  < .001). The cannabis group included significantly higher patients with Marfan syndrome (cannabis: 11.2% vs noncannabis: 4.4%;  < .001). Furthermore, the cannabis group showed significantly higher history of recreational drug use, including cocaine (25.4% vs 1.6%;  < .001), amphetamines (3.7% vs 0.6%;  < .001), opioids (8.2% vs 0.5%;  < .001), and intravenous drugs (6.7% vs 0.6%;  < .001). Emergency surgeries were significantly more frequent in the cannabis group (cannabis: 56.7% vs noncannabis: 36.2%;  < .001). Surgical mortality was comparable between both groups (cannabis: 9.7% vs noncannabis: 8.6%;  = .662). Postoperative stroke was significantly higher in the cannabis group (cannabis: 14.9% vs noncannabis: 8.2%;  = .009), and the rate of postoperative respiratory complications was also significantly higher in the cannabis group (cannabis: 32.1% vs noncannabis: 19.0%;  < .001).

CONCLUSIONS

The increased rates of postoperative cerebrovascular accidents and respiratory complications suggest that cannabis use is a significant risk factor in aortic surgery. Our study showed that young, healthy patients with prolonged cannabis use might be at a higher risk of requiring more emergency surgeries due to their background.