High Risk Endovascular Aneurysm Repair: A Case Report

2017 ◽  
Vol 27 (10) ◽  
pp. 234-236
Author(s):  
S De Silva
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Past History ◽  
Artery Bypass ◽  
Endovascular Aneurysm Repair ◽  
Chronic Obstructive ◽  
Bypass Grafting ◽  
Obstructive Pulmonary Disease ◽  
Abdominal Aortic ◽  
History Of ◽  
Aneurysm Repair

Mr AB is a 66-year old gentleman who presented for elective endovascular aneurysm repair (EVAR) following a routine screening scan identifying a 5.5cm abdominal aortic aneurysm (AAA). He had a past history of chronic obstructive pulmonary disease (COPD) with FEV1/FVC ratio of 48% on pre-assessment. He was hypertensive with a history of ischaemic heart disease (IHD), which has remained asymptomatic following coronary artery bypass grafting (CABG) eight years prior to this presentation.

scholarly journals Postoperative Delirium in Patients with Chronic Obstructive Pulmonary Disease after Coronary Artery Bypass Grafting

Medicina ◽  
2020 ◽  
Vol 56 (7) ◽  
pp. 342
Author(s):  
Aleksandra Szylińska ◽  
Iwona Rotter ◽  
Mariusz Listewnik ◽  
Kacper Lechowicz ◽  
Mirosław Brykczyński ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Cardiac Surgery ◽  
Pulmonary Disease ◽  
Postoperative Delirium ◽  
Artery Bypass ◽  
Chronic Obstructive ◽  
Bypass Grafting ◽  
Obstructive Pulmonary Disease ◽  
Probability Of Survival ◽  
Copd Patients

Background and Objectives: The incidence of postoperative delirium (POD) in patients with chronic obstructive pulmonary disease (COPD) is unclear. It seems that postoperative respiratory problems that may occur in COPD patients, including prolonged mechanical ventilation or respiratory-tract infections, may contribute to the development of delirium. The aim of the study was to identify a relationship between COPD and the occurrence of delirium after cardiac surgery and the impact of these combined disorders on postoperative mortality. Materials and Methods: We performed an analysis of data collected from 4151 patients undergoing isolated coronary artery bypass grafting (CABG) in a tertiary cardiac-surgery center between 2012 and 2018. We included patients with a clinical diagnosis of COPD according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria. The primary endpoint was postoperative delirium; Confusion Assessment Method in the Intensive Care Unit (CAM-ICU) was used for delirium assessment. Results: Final analysis included 283 patients with COPD, out of which 65 (22.97%) were diagnosed with POD. Delirious COPD patients had longer intubation time (p = 0.007), more often required reintubation (p = 0.019), had significantly higher levels of C-reactive protein (CRP) three days after surgery (p = 0.009) and were more often diagnosed with pneumonia (p < 0.001). The CRP rise on day three correlated positively with the occurrence of postoperative pneumonia (r = 0.335, p = 0.005). The probability of survival after CABG was significantly lower in COPD patients with delirium (p < 0.001). Conclusions: The results of this study confirmed the relationship between chronic obstructive pulmonary disease and the incidence of delirium after cardiac surgery. The probability of survival in COPD patients undergoing CABG who developed postoperative delirium was significantly decreased.

Short-term and long-term impact of diagnosed and undiagnosed chronic obstructive pulmonary disease on coronary artery bypass grafting surgery

2021 ◽  
pp. postgradmedj-2020-139341
Author(s):  
Francesca Gatta ◽  
Yama Haqzad ◽  
Mahmoud Loubani
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Coronary Artery ◽  
Artery Bypass ◽  
Chronic Obstructive ◽  
Bypass Grafting ◽  
Obstructive Pulmonary Disease ◽  
Group A ◽  
Group B ◽  
Long Term Mortality

ObjectivesThis study sought to compare clinical outcomes between three categories of patients: non-chronic obstructive pulmonary disease (COPD), diagnosed COPD and undiagnosed COPD in coronary artery bypass grafting surgery.MethodsA single-centred retrospective study from January 2010 to December 2019. Primary outcomes were postoperative complications, length of ITU admission and in-hospital staying. Secondary outcomes were reintervention rate, in-hospital and long-term mortality.ResultsA total of 4020 patients were analysed and divided into three cohorts: non-COPD (group A) (74.55%, n=2997), diagnosed COPD (group B) (14.78%, n=594) and undiagnosed COPD (group C) (10.67%, n=429). The rate of respiratory complications was noted in this order: group B>group C>group A (p 0.00000002). Periooperative acute kidney injury and wound complications were higher in group B (p 0.0004 and p 0.03, respectively). Prolonged in-hospital staying (days) resulted in group B (p 0.0009). Finally, long-term mortality was statistically higher in group B and C compared with group A (p 0.0004). No difference in long-term mortality was noted in relation to the expected FEV1% in group B (p 0.29) and group C (p 0.82).ConclusionsIn CABG surgery, COPD is a well-known independent risk factor for morbidity. Patients with preoperative spirometry results indicative of COPD result in the same outcomes of known patients with COPD. As a result of that, greater value should be given to the preoperative spirometry in the EuroSCORE. Finally, the expected FEV1% appears not be a predictor for long-term survival.

Sign in / Sign up

Export Citation Format

Share Document