Cardiovascular Disease May Be Underestimated in Patients Considered Fit for Open Thoraco-abdominal Aortic Aneurysm Repair: A Retrospective Single Centre Study.

Abstract

This study aimed to investigate the correlation between thoraco-abdominal aortic aneurysms (TAAAs) and pre-existing cardiovascular diseases in patients undergoing open aortic surgery and to ascertain the information derived from pre-operative cardiopulmonary workup. A retrospective, single centre, cross sectional study was conducted on patients who underwent open TAAA repair between 2006 and 2023. Pre-operative cardiopulmonary workup was evaluated to assess the prevalence of comorbidities. The primary outcome was relevant coronary stenosis requiring pre-operative treatment, and the secondary outcome was any other comorbidities identified during cardiac and pulmonary diagnostics. In this study, 304 patients had a complete or partial cardiopulmonary workup, 261 patients were presented with a cardiac workup, and 231 with a pulmonary workup. The mean patient age was 55.3 ± 12.5 years and 30.3% of the patients were women. In this study, 39.9% of patients had pre-existing lung diseases, 21.4% had connective tissue disease, and nearly half had undergone previous aortic surgery. Congestive heart failure was present in 36.5% of patients. Pulmonary function tests identified obstructive patterns in 19.9% and restrictive patterns in 12.3% of patients. During cardiac workup, 15.7% of patients presented cardiac wall motion abnormalities and 17.2% presented stress induced ischaemia. In patients having cardiac catheterisation, significant stenosis requiring pre-operative stenting was present in 30.5%. This study showed the high prevalence of cardiopulmonary diseases in patients with TAAA who are deemed fit for open aortic surgery. It underscores the importance of comprehensive pre-operative cardiopulmonary screening in patients with TAAA and highlights the predictive value of a detailed medical history in identifying patients at risk of coronary stenosis.