Perioperative @entity299 in endovascular repair of complex XXXX and association with preoperative studies.

@entity1 @entity449 @entity943 @entity3386 @entity730 @entity2759 @entity2334 @entity955 @entity299 @entity583 @entity204
BACKGROUND: Endovascular repair of complex @entity449 (CAAs) can be performed in high-risk individuals, yet is still associated with significant morbidity, including @entity2759 , @entity299 , and @entity204 . This analysis was undertaken to better define the cardiac risk for @entity3386 . METHODS: A prospective database of @entity1 undergoing @entity2334 repair with branched and fenestrated endografts was used to retrospectively determine the number of @entity299 , defined as @entity583 ( @entity583 ), @entity955 ( @entity955 ), and @entity943 ( @entity943 ), that occurred  <= 30 days of surgery. Postoperative serial troponin measurements were performed in 266 @entity1 . Any additional available cardiac information, including preoperative echocardiography, physiologic stress tests, and history of @entity299 , was obtained from medical records. The efficacy of preoperative stress testing and the association of various echo parameters were evaluated in the context of cardiac outcomes using univariable and multivariable logistic regression models. RESULTS: Between August 2001 and December 2007, 395 @entity1 underwent endovascular repair of a @entity2334 . The incidence of @entity955 , @entity943 , and 30-day cardiac-related @entity204 was 9%, 3%, and 2%, respectively. Overall 30-day mortality was 6%. Univariable analysis showed the presence of @entity730 was associated with @entity583 (odds ratio [OR], 3.5; 95% confidence interval [CI], 0.9-13.8; P = .07). Left atrium cavity area, ejection fraction, left ventricle mass, and left ventricular mass index were univariably associated with the presence of @entity943 . Multivariable analysis showed only the left atrium cavity area was independently associated with @entity943 (OR, 1.2; 95% CI, 1.0-1.5; P = .07). Stress test was done in 179 @entity1 . Negative stress test results occurred in 152 (85%), of whom 9 (6%) sustained an @entity583 during the 30-day perioperative course. @entity583 occurred in 2 of the 27 @entity1 (7%) who had a positive stress test result. CONCLUSIONS: Endovascular repair of @entity3386 can be performed in high-risk individuals but is associated with significant cardiac risk. It remains difficult to risk stratify @entity1 using preoperative stress testing. Echo evaluation may help to identify @entity1 who may be more likely to develop @entity943 in the postoperative period and thus warrant closer monitoring. Postoperative troponin monitoring of all @entity1 undergoing repair of @entity3386 is warranted given the overall risk of @entity583 .
