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ORIGINAL ARTICLE  VASCULAR SECTION 

The Journal of Cardiovascular Surgery 2020 October;61(5):596-603

DOI: 10.23736/S0021-9509.19.11052-X

Copyright © 2019 EDIZIONI MINERVA MEDICA

lingua: Inglese

Anaerobic threshold as an independent predictor of mid-term survival following elective endovascular repair of abdominal aortic aneurysm

Claire DAWKINS 1, Andrew C. HOLLINGSWORTH 1, Paul WALKER 2, Simon MILBURN 2, Gerard DANJOUX 3, Matthew CHEESMAN 3, Reza MOFIDI 1

1 Department of Vascular Surgery, James Cook University Hospital, Middlesbrough, UK; 2 Department of Interventional Radiology, James Cook University Hospital, Middlesbrough, UK; 3 Department of Anesthesia, James Cook University Hospital, Middlesbrough, UK



BACKGROUND: The aim of this study was to examine the value preoperative AT as predictor of postoperative survival in patients who underwent elective EVAR for repair of asymptomatic AAA.
METHODS: Consecutive patients who underwent elective EVAR between 2008 and 2018 were analyzed. Cardiopulmonary exercise testing was performed. Perioperative 30-day mortality was compared between patients who had AT ≥8 mL/kg/min and those with AT<8 mL/kg/min. Risk factors for postoperative survival following EVAR were examined using Cox’s regression analysis.
RESULTS: Between 1st January 2008 and 31st December 2017, 430 patients underwent elective EVAR (standard device: N.=374, fenestrated/branched: N.=56); their median age was 76 years (range: 53-91 years), median AT was 9.3 (range: 5.4-16.1), and 30-day mortality was 0.9%. These patients were followed up for a median of 1630 days. There was no significant difference in perioperative 30-day mortality between patients who had AT≥8 and those who had AT<8 (χ2=1.56, P=0.22). Age (HR=1.51 [CI: 1.07-1.99], P<0.05) and AT (HR=0.59 [CI: 0.45-0.76], P=0.0003) were predictors of reduced postoperative survival following elective EVAR whereas gender (HR=0.75 [CI: 0.4-1.4], P=0.37), AAA diameter (HR=0.95 [CI: 0.77-1.16], P=0.6), and AAA morphology (HR=1.23 [CI: 0.68-1.76], P=0.95) were not.
CONCLUSIONS: Anaerobic threshold is an independent predictor of prolonged survival following elective EVAR and can be used to identify patients who receive most benefit from elective EVAR.


KEY WORDS: Abdominal aortic aneurysm; Endovascular procedures; Anaerobic threshold; Survival

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