Intoduction: The aim of the study was to assess the usefulness of coronarography in patients suffering from abdominal aortic aneurysm (AAA) or peripheral arteriosclerotic occlusive disease (PAOD) with concomitant ischaemic heart disease.
Methods: The procedure was performed before surgical treatment. In our study, 60 patients were investigated: 48 M/12 F, aged 42–70 years. In the group were 41 cases (68.3%) of AAA and 19 cases (31.6%) of PAOD in angina pectoris stage according to the CCS (Canadian Cardiological Society) scale qualified as II or more. The coronarography was performed in all the patients, and revealed 47 cases (78.3%) of critical stenoses of coronary arteries.
Results: 21 patients (35%) with stenosis of one artery and 2 (3%) with stenoses in 2 arteries) underwent coronary angioplasty (PTCA), usually with stent placement. PTCA was not performed in 3 cases (5%) of monoarterial stenosis, due to the good condition of collateral circulation. In another group of 21 patients (35%) multiarterial disease was diagnosed; 15 of them were qualified for coronary bypass surgery (CABG), and 6 patients were disqualified from surgical treatment (critical lesions in peripheral arteries or good collateral circulation). In 13 cases (21.6%) coronarography revealed no critical lesions in coronary arteries. Surgery of AAA or PAOD was performed in 19 patients 4 weeks after PTCA, and in 6 patients 3 months after CABG. Two patients with multiarterial coronary disease, disqualified from CABG procedure, were not operated for AAA. One PAOD patient with multiarterial coronary disease (disqualified from CABG) died after surgical treatment of PAOD, due to myocardial infarction.
Conclusion: Coronarography should be performed in all patients with AAA or PAOD with concomitant ischaemic heart disease of CCS stage II or more. Highly specialised cardiological evaluation of coronary circulation in those patients allows for appropriate qualification, preparation and optimal timing of elective surgery of AAA or PAOD.