Does coronary angiography before emergency aortic surgery affect in-hospital mortality?
Marc S. Penn, MD, PhDa,
Nicholas Smedira, MDb,
Bruce Lytle, MDb and
Sorin J. Brener, MD, FACCa
a Department of Cardiology, Cleveland Clinic Foundation, Cleveland, Ohio, USA
b Department of Cardiothoracic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA
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Figure 1 Relationship of coronary angiography status and in-hospital mortality in patients undergoing emergency repair of the thoracic aorta. Angiography Yes (n = 41) vs. No (n = 81), p = 0.46.
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Figure 2 In-hospital mortality based on whether patients underwent CABG at time of emergency repair of aorta with or without preoperative coronary angiography. No CABG (n = 85), p = 0.386; CABG (n = 27), p = 1.0. CABG = coronary artery bypass graft.
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Figure 3 Effect of coronary angiography status on frequency of CABG during emergency repair of the aorta. Frequency of CABG due to CAD (open bars) or dissection (filled bars) in patients who had coronary angiography—Yes (n = 41) vs. No (n = 81, p = 0.005). CABG = coronary artery bypass graft; CAD = coronary artery disease.
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Figure 4 (A) Frequency of patients having coronary angiography before emergency repair of the aorta and (B) in-hospital mortality over time. Patients were divided into quintiles (n = 25, 25, 24, 24, 24) with the first quintile (1) including the first patient in 1982 and the fifth quintile (5) including the last patient in 1997. (A) These data demonstrate a statistically significant trend towards the decreased use of coronary angiography at our institution in the preoperative management of patients with life threatening pathology of the aorta (p < 0.001). Due to sample size limitations, a similar analysis could not be made with the data in (B).
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