Immunosuppressive Agents and Thoracic Aortic Aneurysm: Real Correlation or Mere Coincidence?


Journal

The Thoracic and cardiovascular surgeon
ISSN: 1439-1902
Titre abrégé: Thorac Cardiovasc Surg
Pays: Germany
ID NLM: 7903387

Informations de publication

Date de publication:
12 2022
Historique:
pubmed: 19 1 2021
medline: 22 12 2022
entrez: 18 1 2021
Statut: ppublish

Résumé

Atherosclerosis, hypertension, age, and fibrillopathies are well-known risk factors for the development of aortic aneurysm. We discovered that a significant proportion of our patients were previously on chemotherapy treatment or long-term treatment with cytostatic agents or immunosuppressive drugs. Thus, we examined this phenomenon. A total of 224 patients with thoracic aorta aneurysm were retrospectively analyzed after aortic surgery from 2006 to 2016. Seventy-three patients received aortic wrapping and 151 patients underwent aortic replacement of which 89 had a valve-carrying conduit and 62 a supracoronary ascending replacement. Aortic morphology was assessed by means of compute tomography scan before and after surgery. Demographic data, risk profile, and postoperative complications were collected. Short- and long-term survival analysis was performed. Statistical analysis was performed with SPSS 19.0. Eighty-eight of 224 patients undergoing aortic surgery because of aortic aneurysm had previously or currently been treated with immunosuppressive agents. Dilatation of the ascending aorta was more pronounced in patients without such therapy. Demographic profile, intraoperative, as well as short- and long-term postoperative results did not differ significantly between both groups. The potential effect of immunosuppressant and cytostatic therapies on the development of an aortic aneurysm needs further study. Because of the astoundingly high proportion of these patients being found in an unselected aortic aneurysm cohort with immunosuppressive therapy in the past should be monitored for potential development of aortic aneurysm. If it occurs and requires treatment these patients can fortunately be operated upon with the same short- and long-term outcome than patients without such previous therapy.

Sections du résumé

BACKGROUND
Atherosclerosis, hypertension, age, and fibrillopathies are well-known risk factors for the development of aortic aneurysm. We discovered that a significant proportion of our patients were previously on chemotherapy treatment or long-term treatment with cytostatic agents or immunosuppressive drugs. Thus, we examined this phenomenon.
METHODS
A total of 224 patients with thoracic aorta aneurysm were retrospectively analyzed after aortic surgery from 2006 to 2016. Seventy-three patients received aortic wrapping and 151 patients underwent aortic replacement of which 89 had a valve-carrying conduit and 62 a supracoronary ascending replacement. Aortic morphology was assessed by means of compute tomography scan before and after surgery. Demographic data, risk profile, and postoperative complications were collected. Short- and long-term survival analysis was performed. Statistical analysis was performed with SPSS 19.0.
RESULTS
Eighty-eight of 224 patients undergoing aortic surgery because of aortic aneurysm had previously or currently been treated with immunosuppressive agents. Dilatation of the ascending aorta was more pronounced in patients without such therapy. Demographic profile, intraoperative, as well as short- and long-term postoperative results did not differ significantly between both groups.
CONCLUSION
The potential effect of immunosuppressant and cytostatic therapies on the development of an aortic aneurysm needs further study. Because of the astoundingly high proportion of these patients being found in an unselected aortic aneurysm cohort with immunosuppressive therapy in the past should be monitored for potential development of aortic aneurysm. If it occurs and requires treatment these patients can fortunately be operated upon with the same short- and long-term outcome than patients without such previous therapy.

Identifiants

pubmed: 33461219
doi: 10.1055/s-0040-1721675
doi:

Substances chimiques

Immunosuppressive Agents 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

637-644

Informations de copyright

Thieme. All rights reserved.

Déclaration de conflit d'intérêts

Disclosure The authors report no conflicts of interest in this work.

Auteurs

Roya Ostovar (R)

Department of Cardiovascular Surgery, Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Bernau bei Berlin, Brandenburg, Germany.

Magdalena Laux (M)

Department of Cardiovascular Surgery, Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Bernau bei Berlin, Brandenburg, Germany.

Ralf-Uwe Kuehnel (RU)

Department of Cardiovascular Surgery, Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Bernau bei Berlin, Brandenburg, Germany.

Filip Schroeter (F)

Department of Cardiovascular Surgery, Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Bernau bei Berlin, Brandenburg, Germany.

Christian Braun (C)

Department of Cardiovascular Surgery, Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Bernau bei Berlin, Brandenburg, Germany.

Michael Erb (M)

Department of Cardiovascular Surgery, Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Bernau bei Berlin, Brandenburg, Germany.

Johannes M Albes (JM)

Department of Cardiovascular Surgery, Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Bernau bei Berlin, Brandenburg, Germany.

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Classifications MeSH