All Arterial operations and interventions are considered major procedures. It is important to take the time to fully understand the planned procedure, its risks and the recovery process. Most arterial problems are clustered in older patients. The incidence climbs steadily from the sixties and up. The conditions are all more common in people with a history of smoking. There is a large overlap with diabetes as well. Heart disease and risk of stroke are also clustered in the same way. For this reason it is important that a risk assessment be carried out in planning the surgery. Much of this is done by the questions about exercise tolerance we pose in the review as well as blood tests. In patients with a clear history of active heart problems or who have severe activity limitations these questions may not be adequate and more specific testing may be needed to assess the risk and suitability for surgery. The need for us to organize these heart and lung function tests will necessarily delay a decision regarding surgery. They are however critical to formulating an effective plan.
You will need tests under the following conditions:
- If you are unable to walk a city block (100 meters) on level ground
- If you are unable to walk up a flight of stairs (8-10 steps) without pausing
- If you have chest pain or shortness of breath on exertion
- If you have a history of heart failure
It may be necessary to involve other medical specialists in order to ensure that you are in the best condition possible for the planned procedures. Much of this can be anticipated even before your first visit by discussing these limitations with you family doctor and initiating the process in advance. Having these matters addressed early allows us to focus on a timely intervention for the problem at hand.
Patients with Diabetes:
All patients with Diabetes who are proceeding with arterial surgery are likely to experience increased blood sugar in the post operative period. In order to regulate it there may be a need for adding insulin injections for people who previously not required it. In patients already on insulin there may be more adjustments in dosage needed. We will need to arrange an appropriate specialist consultation for this purpose unless you are already under the care of a Victoria based specialist who can help manage this problem while you are in the hospital.
Planning For Hospital Discharge
Please see the most appropriate section regarding the recovery process and discharge planning following the specific type of surgery you are having.
- Aortic Aneurysm repair
- EVAR (Aortic Stent graft repair)
- Lower limb bypass / Surgical Bypass
- Carotid endarterectomy