79-year-old man for consideration of open vs endovascular AAA repair.
- 5.1cm infra-renal AAA
- OA knee – awaiting TKR
- Previously discussed at PIG meeting
- Desaturated significantly during CPET test: 96-84%. Asymptomatic
- Limited by knee pain, no dyspnoea.
- Spirometry – restrictive ventilatory defect. FEV1=2.28 (75%), FVC= 2.72 (67%)
- CXR – bilateral pulmonary infiltrates
- CT chest showed fibrosing interstitial lung disease – new diagnosis
Suitability for open procedure?
- Awaiting respiratory review but consensus that this patient is optimised
- Endovascular approach would be preferable
- Open AAA repair reasonable in with effective regional analgesia and postoperative care
- ICU 2 for open procedure
- As above, await respiratory consult and surgical plan.