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20 Cards in this Set
- Front
- Back
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Incidence of Vascular surgery |
Decreased from 6 day mortality of >25%- from major aortic repair to <2% for a 30 day mortality- Endovascular Abdominal aneurysm Repair |
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Athersclerosis |
A generalized inflammatory disorder of the arterial tree with associated endothelial damage |
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What are typical causes of endothelial damage? |
Hemodynamic shear->HTN. Inflammation-> Usually chronic infections. Hypercoagulability->thrombosis. Effects of LDLs->oxidized LDLs. |
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Mortality rates of major Vascular Surgery |
4.3% |
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What are objectives of preop for major vascular surgery? |
•Accuraterisk assessment •Optimizationof comorbid medical conditions•Referralsto specialists as required•Postoperativecare facility |
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How are objectives achieved in preop for major vascular surgery? |
•History,PE (with emphasis of CV systems), FRC (aerobic fitness), targetedinvestigations into comorbidities |
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What happens to complication rate as people age? |
Postop neuro complications and postop renal failure after CABG increases with age |
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Cardiac disease is present in how many vascular patients? |
25-60% |
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Coronary artery disease is present in what percentage of patients undergoing vascular surgery? |
60% |
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Stable Angina -Class 1 & Class 2 |
has minimal risk of perioperative events as long as the condition is medically optimized |
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CCS Class 1 |
Angina with strenuous exercise- rapid stair climbing |
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CCS Class 2 |
Angina with moderate exertion- long distance walking, walking on an incline |
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CCS Class 3 |
Angina with mild exertion- climbing one flight of stirs at normal pace |
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CCs Class 4 |
Angina at rest or on minimal exertion |
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What is major cause of morbidity and mortality following vascular surgery? |
Cardiac Failure |
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What is most common valvular lesion in vascular surgery patients? |
Aortic Stenosis |
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When do you need to consider surgical correction of Aortic Stenosis? |
Gradient >60 mm. or <1 cm2 |
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If patient has mitral stenosis, what should be expected? |
Carries increased risk if severe and correction should be considered if severe |
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What cardiac conditions should be "optimized" before vascular surgery? |
HTN and arrythmias |
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Dental. Poor dentition risk |
Associated with CAD. At risk for tooth dislodgement. Risk of Bacteremia |
