Cardiac complications and their prevention in surgery of infrarenal abdominal aortic aneurysms

We analyzed the data of surgical treatment of 225 patients with infrarenal abdominal aortic aneurysms (AAA) obtained over a period from 1998 to 2012. Depending on the tactics and methods of surgical treatment, the patients were divided into 3 groups. Group 1 included 79 patients (35,2%), who underwent open surgery for AAA with therapeutic correction of combined pathology in the blood pool of the heart. Group 2 had 118 patients (52,4%), who underwent first surgical correction of the arterial bed of the heart and then open surgery for AAA. 28 patients of Group 3 (12,4 %) also underwent first surgical correction in the arterial bed area followed, however, by endovascular repair of AAA. Preliminary surgical correction of the coronary blood flow abnormalities followed by open surgery of AAA allowed to reduce the number of myocardial infarctions in the early postoperative period from 10,1 % to 1,7% and from 12,5% to 1,3% in the long-term period, to reliably reduce perioperative mortality from 10,1% to 0,8% and to improve the actuarial 5-year survival from 77,5% to 91,3%. The absence of cardiac complications after preliminary surgical correction of the coronary blood flow and endovascular repair of AAA both during early and long-term follow-up is indicative of the benefits of this tactic, especially for the elderly with multiple co-morbidities.