Abdominal aortic aneurysm (AAA) can rupture and lead to internal bleeding. The patients risk severe complications, including death. It is treated by aortic reconstruction using endovascular repair(EVR) and grafts. This study evaluates the aortic stiffness and blood flow to improve surgical outcomes.
The observational study involved a cohort of 73 consecutive male patients with AAA. Sixty-one of them had EVR, while 12 had open incision repairs. Their carotid-femoral pulse wave velocity (cf-PWV) was 1-week preoperatively estimated. The left ventricular global longitudinal strain GLS was used to identify early systolic dysfunction. Researchers also did post-op estimates at 1 and 6 months.
The cf-PWV had a significant time effect after one month. It increased and sustained the rise through 6 months with a probability of 0.007. The GLS value deteriorated with a significant change at one month, and this change persisted with a P<0.001 for six months. The EVAR and open repair revealed no significant interaction or group effect. The GLS value differences at baseline and six months significantly correlated with corresponding cf-PWV changes.
The study shows a lowered systolic function of the heart after AAA surgery. The increase in pulse wave velocity indicated aortic stiffness too. The cardiac surveillance program has to be intensified after aortic reconstruction surgery. Further studies have to investigate this program and translate it into management procedures for long-term symptoms and complications.
Ref: https://journals.sagepub.com/doi/full/10.1177/1526602820976636
