- Oral presentation
- Open Access
Emergencies in cardiovascular surgery
© Mitrev and Anguseva; licensee BioMed Central Ltd. 2013
- Published: 11 September 2013
- Congenital Heart Disease
- Aortic Aneurysm
- Aortic Dissection
- Abdominal Aortic Aneurysm
- Acute Aortic Dissection
Urgent surgery is part of a daily practice on cardiovascular units, and it may be required in patients with conditions such as acute coronary syndrome, endocarditis and valvular diseases, trauma, acute aortic dissection as well as acute vascular embolisations and Leriche syndrome.
In emergency situation, preoperative patient work-up for cardio-vascular surgery is quite different from the elective setting. Since 03/2000 till 01/2012 we have analyzed a consecutive series of 12 172 cases out of which 2214 underwent emergency procedures (18.19%). The most frequent problems requiring urgent intervention were thoracic aortic aneurysms (448 cases; 20.24%); coronary artery disease (1006 cases; 45.47%) abdominal aortic aneurysms (125 cases - 66 with rupture; 2.96%), peripheral vascular (364 cases; 16.46%), and others (329 cases: 14.87%).
Urgent thoracic and abdominal aortic aneurysm repair accounted for 23% respectively and the corresponding proportion for peripheral vascular surgery is 16%. However, urgent surgery for acute coronary ischemia, valvular and congenital heart disease accounted for somewhat less than 60% for each group of these pathologies. Mortality rate was 43 (1.91%).
Systematic pre-operative diagnostic work-up is a recognized tool for procedure related risk assessment and superior management of diseases. However, hemodynamic instability and other time related events correlated with negative outcome, are the main driving forces for accelerated diagnostic pathways.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.