Кардиальные осложнения и их профилактика в хирургии аневризм брюшной аорты

Purpose. To compare and evaluate the nature of events after different revascularization strategies in patients with infrarenal aortic aneurysm and concomitant ischemic heart disease and, based on the analysis of the obtained data, to choose the safest revascularization strategy in this category of patients. Material and methods. The treatment results were assessed in the two groups of patients. Group 1 included 79 (40,1 %) patients, who underwent an open surgery for abdominal aortic aneurysm with pharmacological treatment of the concomitant coronary disease, and Group 2 consisted of 118 (59,9 %) patients, who first underwent surgical and/or endovascular coronary revascularization and then an open surgery for abdominal aortic aneurysm. Results. Group 2 was found to have significantly less cardiovascular events and less cardiovascular mortality, which was due to the approach consisting in all the abdominal aortic aneurysm patients undergoing coronary angiography and, in case there was a stenotic coronary lesion, coronary revascularization was performed first with a surgery for abdominal aortic aneurysm being done afterwards. Conclusion. Coronary angiography in patients with infrarenal aortic aneurysm can help identify the group of patients who would benefit from first-stage coronary revascularization, which could lead to less cardiac events and less surgical mortality when abdominal aortic aneurysm is treated.