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Current practice in the pre‐operative assessment of patients for elective repair of abdominal aortic aneurysm
Author(s) -
Pullman M. D.,
Edwards N. D.
Publication year - 1997
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.1997.az0083b.x
Subject(s) - medicine , abdominal aortic aneurysm , aneurysm , ejection fraction , surgery , cardiology , heart failure
A postal survey of 100 hospitals throughout the United Kingdom and Ireland was conducted to assess current practice in the pre‐operative assessment and use of pulmonary artery catheters in patients undergoing elective abdominal aortic aneurysm repair. Seventy‐four completed questionnaires were received. The survey revealed that 53% of respondents hold designated pre‐operative assessment clinics, attended by anaesthetists in 54% and cardiologists in 26%. However, only 4% of respondents have a written protocol for stratifying patients and assessing peri‐operative risk. By far the commonest investigation of choice for further cardiological assessment is transthoracic echocardiography (67%). Other investigations of choice are multiple update gated acquisition (MUGA) scan (13%), dipyridamole thallium imaging (9%), exercise ECG (6%), stress echocardiography (1%) and stress MUGA (1%). Two units (3%) never undertook further investigation. Pulmonary artery flotation catheters are used as a routine by 9% of respondents, dependent upon left ventricular ejection fraction by 65%, dependent on other factors by 7% and not used at all by 19%. The survey reveals widespread variation in pre‐operative assessment of patients undergoing elective repair of abdominal aortic aneurysm.