RESUMO
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 preoperative 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.
Assuntos
Aneurisma da Aorta Abdominal/cirurgia , Testes Diagnósticos de Rotina/estatística & dados numéricos , Prática Profissional , Cateterismo Cardíaco/estatística & dados numéricos , Angiografia Coronária/estatística & dados numéricos , Procedimentos Cirúrgicos Eletivos , Testes de Função Cardíaca/estatística & dados numéricos , Humanos , Irlanda , Ambulatório Hospitalar , Artéria Pulmonar , Inquéritos e Questionários , Reino UnidoRESUMO
The surgical correction in the primary position was compared in one group of patients who underwent horizontal surgery without an A or V pattern with a matched group who underwent horizontal surgery with monocular vertical displacement for the A and V patterns. No significant difference was found, and it was concluded that the determination of the amount of horizontal surgery is the same whether monocular vertical displacement is performed or not.