Endovascular vs open abdominal aortic aneurysm repair: a comparison of cardiac morbidity and mortality

Abstract

Hypothesis: Adverse cardiac event rates following endovascular abdominal aortic aneurysm (EAAA) and open abdominal aortic aneurysm (OAAA) repair are similar. We also hypothesized that the Eagle criteria (Q wave on electrocardiogram, diabetes, angina, congestive heart failure, age >70 years, and ventricular ectopy) are useful predictors of cardiac events in patients undergoing EAAA repair.

Design: Prospective (patients undergoing EAAA repair) and retrospective (patients undergoing OAAA repair).

Setting: Public teaching and Veterans Affairs medical centers.

Patients: Eighty-three EAAA and 63 OAAA repairs.

Main outcome measures: Myocardial infarction, congestive heart failure, and cardiac death.

Results: Patients with EAAA were older (73 vs 68 years, P=.003). There were no differences in the mean number of Eagle criteria (1.2 vs 1.3), cardiac event rates (6% vs 4.8%), or mortalities (3.6% vs 4.8%). Within the EAAA group, congestive heart failure (P=.005) and Q wave on electrocardiogram (P=.006) were the only predictors of cardiac events.

Conclusions: Patients undergoing OAAA and EAAA repair had similar cardiac event rates and mortality. In patients undergoing EAAA repair, history of congestive heart failure and Q wave on electrocardiogram were predictors of cardiac events.