Outcomes of thoracic aortic surgery in patients with coronary artery disease: Based on the Japan adult cardiovascular surgery database

Masahiro Daimon, Hiroaki Miyata, Noboru Motomura, Yutaka Okita, Shinichi Takamoto, Sachiko Kanki, Takahiro Katsumata

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)

Abstract

Background: Coronary artery disease (CAD) is associated with increased morbidity and mortality after open repair of thoracic aorta. Nevertheless, the efficacy of preoperative coronary angiography (CAG) and revascularization is controversial. The aim of this study was to clarify the effect of preoperative CAD on surgical outcome by reviewing the Japan Adult Cardiovascular Database. Methods and Results: This study involved 4,596 patients who underwent open surgery for true thoracic aortic aneurysm between 2004 and 2009. After excluding patients with concomitant cardiac operation, except coronary artery bypass grafting (CABG), the remaining 1,904 patients with coronary artery stenosis included 995 cases of simultaneous CABG. The prevalence of CAD was significantly higher in patients with diabetes, renal dysfunction, hyperlipidemia, cerebrovascular disorders, peripheral artery lesions, old myocardial infarction (MI), and coronary intervention. Patients with simultaneous CABG had severe CAD compared with those without, with no other major differences in patient background noted. Thirty-day postoperative and in-hospital mortalities were higher in CAD patients. Incidence of perioperative MI was higher in patients who underwent open aortic repair with simultaneous CABG, but simultaneous CABG did not affect operative mortality. Conclusions: In patients with surgically treated true aortic aneurysm, CAD was frequently observed, suggesting that aggressive preoperative coronary evaluation is needed.

Original languageEnglish
Pages (from-to)978-984
Number of pages7
JournalCirculation Journal
Volume83
Issue number5
DOIs
Publication statusPublished - 2019
Externally publishedYes

Keywords

  • Coronary artery disease
  • Database
  • Thoracic aortic disease
  • Thoracic aortic surgery

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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