Outcomes after open repair of aortic aneurysms and dissections in cannabis consumers.

P0239 

Abstract Submission 

Lucas Ribe (1), Yuki Ikeno (1), Akiko Tanaka (2), Rana Afifi (3), Harleen Sandhu (4), Charles Miller (5), Anthony Estrera (2)

(1) McGovern Medical School at UTHealth, Houston, TX, (2) Memorial Hermann Heart and Vascular Institute, Houston, TX, (3) Memorial Hermann, Houston, TX, (4) N/A, HOUSTON, TX, (5) Memorial Hermann Texas Medical Center, Houston, TX

Lucas Ribe    -  Contact Me
McGovern Medical School at UTHealth

Yuki Ikeno    -  Contact Me
McGovern Medical School at UTHealth

Akiko Tanaka    -  Contact Me
Memorial Hermann Heart and Vascular Institute

Rana Afifi    -  Contact Me
Memorial Hermann

Harleen Sandhu    -  Contact Me
N/A

Charles Miller    -  Contact Me
Memorial Hermann Texas Medical Center

*Anthony Estrera    -  Contact Me
Memorial Hermann Heart and Vascular Institute

Lucas Ribe    -  Contact Me
McGovern Medical School at UTHealth

Objective:
The purpose of this study was to investigate the impact of cannabis consumption on the mid and long-term surgical outcomes of patients with aortic aneurysms or dissections.

Methods:
All individuals aged > 18 years with more than 6 months of cannabis use at the time of surgical repair for cardiovascular disease (aortic aneurysms or aortic dissection) between 2007 and 2023 were eligible. Patients were stratified into two groups based on their preoperative history of marijuana use: Cannabis-users and non-cannabis users. The primary endpoint was complications or death within 30 days of intervention. Secondary outcomes included late complications and re-interventions. Data were combined from our institution (the University of Texas Health Science) and inpatient records from Memorial Hermann Hospital (Houston, Texas).

Results:
During the study period, we identified 134 patients who met the inclusion criteria out of 1,543 treated patients (9%). Compared to the non-cannabis group, individuals in the Cannabis group were significantly younger (Cannabis: 48.3 ± 11.8 years vs. non-Cannabis: 58.5 ± 14.9 years, p < 0.001). The Cannabis group included significantly higher patients with Marfan syndrome (Cannabis: 11.2% vs. non-Cannabis: 4.4%, p<0.001). Furthermore, the Cannabis group showed significantly higher history of recreational drug use, including cocaine (25.4% vs. 1.6%, p<0.001), amphetamines (3.7% vs. 0.6%, p<0.001), opioids (8.2% vs. 0.5%, p<0.001), and intravenous drugs (6.7% vs. 0.6%, p<0.001). Emergency surgeries were significantly more frequent in the Cannabis group (Cannabis: 56.7% vs. non-cannabis: 36.2%, p<0.001). Surgical mortality was comparable between both groups (Cannabis: 9.7% vs. non-cannabis: 8.6%, p=0.662). Postoperative stroke was significantly higher in the Cannabis group (Cannabis: 14.9% vs. non-cannabis: 8.2%, p=0.009), and the rate of postoperative respiratory complications was also significantly higher in the Cannabis group (Cannabis: 32.1% vs. non-cannabis: 19.0%, p<0.001).

Conclusions:
The increased rates of postoperative cerebrovascular accidents and respiratory complications suggest that cannabis use is a significant risk factor in aortic surgery. Our study showed that young, healthy patients with prolonged cannabis use might be at a higher risk of requiring more emergency surgeries due to their background.

Genetics of Aortic Disease