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

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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 2011

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Coronary Angiography
Aortic Valve
Safety
Acute Kidney Injury
Creatinine
Coronary Vessels
Serum
Research Design
Morbidity

ASJC Scopus subject areas

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

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Safety of same-day coronary angiography in patients undergoing elective aortic valve replacement. / Greason, Kevin L.; Englberger, Lars; Suri, Rakesh M.; Park, Soon J.; Rihal, Charanjit S.; Pislaru, Sorin V.; Schaff, Hartzell V.

In: Annals of Thoracic Surgery, Vol. 91, No. 6, 06.2011, p. 1791-1796.

Research output: Contribution to journalArticle

Greason, Kevin L. ; Englberger, Lars ; Suri, Rakesh M. ; Park, Soon J. ; Rihal, Charanjit S. ; Pislaru, Sorin V. ; Schaff, Hartzell V. / Safety of same-day coronary angiography in patients undergoing elective aortic valve replacement. In: Annals of Thoracic Surgery. 2011 ; Vol. 91, No. 6. pp. 1791-1796.
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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.",
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T1 - Safety of same-day coronary angiography in patients undergoing elective aortic valve replacement

AU - Greason, Kevin L.

AU - Englberger, Lars

AU - Suri, Rakesh M.

AU - Park, Soon J.

AU - Rihal, Charanjit S.

AU - Pislaru, Sorin V.

AU - Schaff, Hartzell V

PY - 2011/6

Y1 - 2011/6

N2 - 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.

AB - 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.

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