Cardiac risk stratification in patients undergoing endovascular aortic repair.

Cardiac risk stratification in patients undergoing endovascular aortic repair. Minerva Cardioangiol. 2015 Oct 16; Authors: Biagi P, de Donato G, Setacci C Abstract Endovascular aortic repair (EVAR) for abdominal aortic aneurysms (AAA) is the preferred first treatment option in case of patients with advanced age and/or fit anatomy owing to shorter length of in hospital staying, less complications or laparotomy-related re- interventions, and lower initial costs. Although it is a less-invasive intervention, EVAR entails a risk similar to that of open aortic procedures for medical comorbidities, and a perioperative clinical evaluation is mandatory to minimize the early and late cardiovascular risk. In this brief review the determinants of cardiac risk (functional capacity, cardiac evaluation, non-invasive tests, bio markers and "specialist " cardiac tests) as well the most widely used predictive risk scores were analyzed. Taking into account that a pre-operative cardiovascular assessment is conditioned by the urgency of the repair, in everyday practice rarely the patient undergoes over a complete and exhaustive cardiac assessment with the exclusion of few selected cases that do not represent the rule. Moreover most of models focused on perioperative mortality, tailored for open repair and then adjusted to EVAR or specifically retailed for this procedure show both differences and remarkable similarities. None defines the patient's cardiac...
Source: Minerva Cardioangiologica - Category: Cardiology Tags: Minerva Cardioangiol Source Type: research