P239. Outcomes After Open Repair of Aortic Aneurysms and Dissections in Cannabis Consumers.
McGovern Medical School at UTHealth
Houston, TX
United States - Contact Me
Avanced Aortic Surgery Fellow at Memorial Hermann Hospital, Houston.
I currently live in Houston, where I am completing a two- year Fellowship in advanced aortic surgery. I am greatly engaged in open surgery for aortic aneurysms and dissections, as well as in modern vascular surgery, with large interest in vascular innovations, latest technology in vascular and aortic endovascular surgery, and greatly interested in medical and academic education, as well as surgical simulation.
I previously joined La Fe University Hospital in 2014 as a junior physician in angiology and vascular surgery, within the department of vascular surgery.
Prior to La Fe, I was the first Spanish junior vascular surgeon to complete a senior clinical Fellowship in aortic surgery at St. Mary’s Hospital, Imperial College of London, during an 18- month period,
and one of the first Spanish surgeons to become an official fellow of the European board of vascular and endovascular surgery (FEBVS).
Prior to this experience, I completed my residency in vascular surgery at Gregorio Marañón University hospital in Madrid, during a five- year period.
During my tenure in Madrid, I helped the hospital with the medical and residents training program, and participated in several national and international simulation courses, workshops, and meetings.
I am a graduate of the University of Alcala in Madrid, where I majored my bachelor in medicine.
Description
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.
Authors
Lucas Ribe (1), Yuki Ikeno (1), Akiko Tanaka (2), Rana Afifi (3), Harleen Sandhu (4), Charles Miller (5), Anthony Estrera (2)
Institutions
(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