Annals of vascular surgery
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Renovascular disease is associated with left ventricular hypertrophy (LVH) and left ventricular diastolic dysfunction, both of which are associated with increased mortality and cardiovascular events. However, the effects of renal artery revascularization on cardiac morphology and function are poorly understood and largely based upon retrospective studies. In order to characterize changes in ventricular function and morphology following renal artery revascularization, we identified a cohort of patients with baseline preoperative echocardiograms and studied them with repeat echocardiography at 6-12 months postrevascularization. ⋯ Interval decreases in left ventricular mass were observed following renal artery revascularization, while diastolic function was largely unchanged. Regression of LVH has been associated with reduced mortality and cardiovascular morbidity, and further investigation is required to understand the long-term effects of renal revascularization on survival and ventricular function. Assessment of cardiac function in the setting of symptomatic renal artery stenosis should include evaluation for diastolic dysfunction, which may represent the predominant form of target organ damage in patients with this diagnosis.
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We evaluated national outcomes after open repair of abdominal aortic aneurysms (AAAs) with visceral or renal bypass (VRB). ⋯ VRB repair volume decreased per year similarly to open IRA repair volume and may be related to increasing use of endovascular therapy. Mortality after VRB is high and dependent upon age, renal failure, and congestive heart failure. Overall, VRB repair was associated with worsened outcomes; however, this study cannot conclude that avoiding such a repair will improve outcomes. This should be factored into surgical decision making for these patients.