Trends in cardiac morbidity and mortality after endoluminal abdominal aortic aneurysm repair

Hypothesis: The adverse cardiac event rate following endoluminal abdominal aortic aneurysm (EAAA) repair has decreased as experience in performing the procedure has increased. Aneurysm complexity affects the rate of adverse c ardiac events. Design and Patients: Data from 173 consecutive patients undergoing EAAA rep air from 2 successive periods were compared. There were 82 patients in the early group (group 1) and 91 patients in the later group (group 2). Main Outcome Measures: Myocardial infarction, congestive heart failure, uns table angina, major dysrhythmias, death. Results: The cardiac event rate was 8.5% for group 1 vs 16.5% for group 2 ( P=.16). Predictors of adverse cardiac events on multivariate analysis were the use of 4 or more graft extensions (P=.04), female sex (P=.01), and numb er of Eagle risk factors (P<001). There were 2 postoperative deaths (2.4%) in group 1 and 4 (4.4%) in group 2 (P=.7). Conclusions: Following EAAA repair: (1) adverse cardiac events were found t o correlate with use of 4 or more graft extensions, female sex, and the num ber of Eagle risk factors; (2) cardiac morbidity and mortality remain signi ficant despite greater experience and improved technology; and (3) operativ e mortality remains acceptably low.