SCOTTSDALE, ARIZ. — Patients who undergo endovascular repair of an abdominal aortic aneurysm are significantly less likely to experience myocardial damage than are patients undergoing open repair, Dr. James May said at an international congress on endovascular interventions sponsored by the Arizona Heart Foundation.
In a review of 149 consecutive patients undergoing elective abdominal aortic aneurysm (AAA) repair, Dr. May and colleagues found that 25% of 36 patients undergoing an open repair had elevated levels of troponin T following the procedure. By contrast, only 8% of 113 patients undergoing endovascular repair had elevated troponin T levels post procedure.
“This finding should be taken into account when deciding on the method of AAA repair, even when the patient is considered low risk for an open repair,” said Dr. May, of the department of vascular surgery at the Royal Prince Alfred Hospital, Sydney, Australia.
He said although it has been assumed that endovascular repair of AAAs is generally less traumatic, this hypothesis had never been measured biochemically. Serum troponin T level is an accepted indicator of subclinical myocardial damage.
The study considered a positive finding of myocardial damage to be a 50% of greater increase in serum troponin T after the procedure, compared with before, without a significant increase in serum creatinine. Only one patient had clinically obvious myocardial ischemia after the procedure, and that patient was in the open repair group.
There were no significant differences in age between the two groups of patients, but the patients who underwent endovascular repair were significantly more likely to have had a previous myocardial infarction (41% vs. 21%).