Safety of same-day coronary angiography in patients undergoing elective aortic valve replacement

Kevin L. Greason, Lars Englberger, Rakesh M. Suri, Soon J. Park, Charanjit S. Rihal, Sorin V. Pislaru, Hartzell V. Schaff

Research output: Contribution to journalArticle

27 Scopus citations

Abstract

Background: Coronary artery imaging is required for most adult patients undergoing aortic valve replacement (AVR). Methods: Between January 1, 2000, and December 31, 2007, 1413 patients underwent elective AVR at Mayo Clinic. Two propensity-matched groups at low risk for acute kidney injury were created: 321 patients with coronary angiography on the same day as AVR (same day) and 321 patients with coronary angiography more than 1 day before AVR (non-same day). We defined acute postoperative kidney injury with Acute Kidney Injury Network criteria (< 0.3 mg/dL or a 50% increase in serum creatinine from baseline). Results: The same-day vs non-same-day groups were comparable in age (mean [SD] years: 70.6 [11.0] vs 70.8 [11.5]), sex (111 women [34.6%] vs 114 women [35.5%]), preoperative serum creatinine (1.14 [0.22] vs 1.15 [0.23] mg/dL), and ejection fraction (0.62 [0.12] vs 0.61 [0.12]). Coronary artery revascularization was performed in 118 patients (36.8%) in the same-day group and in 123 (38.3%) in the non-same-day group (p = 0.68). Maximum (30-day) postoperative serum creatinine levels were not significantly different between the same-day and non-same day groups (1.30 [0.43] mg/dL vs 1.29 [0.42] mg/dL; p = 0.87). Perioperative (30-day) acute kidney injury occurred in 75 patients (23.4%) in the same-day group and in 71 (22.3%) in the non-same-day group (p = 0.99). Perioperative (30-day) death occurred in 5 patients (1.6%) in the same-day group and in 7 (2.2%) in the non-same-day group (p = 0.56). Other nonfatal complications rates were comparable between groups. Conclusions: In properly selected patients, coronary angiography can be performed the same day as elective AVR with no increase in perioperative morbidity or death.

Original languageEnglish (US)
Pages (from-to)1791-1796
Number of pages6
JournalAnnals of Thoracic Surgery
Volume91
Issue number6
DOIs
StatePublished - Jun 1 2011

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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