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CURRENT ISSUETHE JOURNAL OF CARDIOVASCULAR SURGERY

A Journal on Cardiac, Vascular and Thoracic Surgery


Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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The Journal of Cardiovascular Surgery 2009 February;50(1):93-107

MANAGEMENT OF THE “POLYVASCULAR PATIENT”
Abdominal aortic aneurysms and concomitant coronary artery disease 

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Coronary artery disease in patients with abdominal aortic aneurysm: a review article

Van Kuijk J. P. 1, Flu W. J. 1, Dunckelgrun M. 2, Bax J. J. 3, Poldermans D. 1

1 Department of Anesthesiology Erasmus Medical Centre The Netherlands
2 Department of Vascular Surgery Erasmus Medical Centre, The Netherlands
3 Department of Cardiology Leiden University Medical Centre, The Netherlands

Abdominal aortic aneurysms (AAA) and coronary artery disease (CAD) have traditionally been regarded as two separate vessel disorders with a common background. Atherosclerosis has always been considered as the basic pathophysiologic process. However, during the last decade, evidence has emerged with differences between AAA and CAD. Firstly, data regarding the prevalence of AAA and CAD are different. Secondly, the risk profiles between AAA and CAD differ, mainly regarding gender, age and diabetes mellitus. Thirdly, despite the intensive treatment of CAD and improved outcome, the prevalence of AAA has not changed during the last decade. In this review we will discuss the characteristics of CAD in patients with AAA. In the first part we focus on epidemiological data of CAD in AAA patients. The pathophysiology of both AAA and CAD will be described in the second part. There is a common pathway between pathophysiology and risk profiles that is discussed in the third chapter. Based on the presence of risk factors and their influence on cardiovascular events, the preoperative work-up and testing for CAD in AAA has gained an important role. The role of (non)-invasive testing will be described in the fourth chapter. The treatment of AAA traditionally consisted solely of surgery. However, due to the influence of CAD on adverse outcomes, medical intervention is potentialy useful. Surgical approaches for the treatment of both AAA and CAD, and most importantly, their influence on long-term outcome will be discussed in the fifth chapter.

language: English


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