Aortic Aneurysm Protocol

Standard preoperative workup

  • History and examination (make sure to document whether the peripheral pulses are palpable)
  • ECG and Chest x-ray
  • Ultrasound aorta will usually have been done as an outpatient and need not normally be repeated.
  • CT abdomen (3mm slices, aortic protocol)
  • Bloods:
    • FBC
    • U&E
    • T/S & XM for 6 units
    • Coag screen
    • LFT
    • ABG
  • Cardiac assessment: If no history of cardiac disease or hypertension, Echo to evaluate ejection fraction. If cardiac disease (previous CABG, PCI or unstable angina) or echo less than 40%, cardiology consult. Please have ECG, CXR, +/- ECHO and Holter, cardiac meds and cardiac enzyme profile (as appropriate) available at the time of consult.
  • Pulmonary assessment: CXR; PFTs; ABG if significant respiratory disease. Consult respiratory physician if attending regularly, PFTs significantly abnormal abnormal or significant respiratory disease. Blood gases may be required in those with abnormal PFTs.
  • Ensure patient and family have been informed of the risks of surgery and been given an information leaflet
  • Pre and post operative chest physiotherapy
  • Book PACU/ICU as appropriate.