[Preoperative assessment in emergency cardiovascular surgery]

Area of Science:

• Cardiovascular Surgery
• Emergency Medicine
• Vascular Surgery

Background:

• Preoperative patient work-up for cardiovascular surgery varies between emergency and elective settings.
• Emergency procedures represent 14.8% of all cardiovascular surgeries analyzed.
• Hemodynamic instability and time-sensitive events drive accelerated diagnostic pathways in emergencies.

Purpose of the Study:

• To analyze the types and frequencies of emergency cardiovascular surgical procedures.
• To compare the proportion of urgent interventions across different cardiovascular pathologies.
• To understand the factors influencing accelerated diagnostic pathways in emergency cardiovascular surgery.

Main Methods:

• Analysis of a consecutive series of 5576 cardiovascular surgery cases.
• Categorization of emergency procedures by primary pathology.
• Calculation of the proportion of urgent procedures relative to elective operations for various conditions.

Main Results:

• Peripheral vascular (22.6%), coronary artery disease (19.0%), and thoracic aortic aneurysms (10.4%) were the most frequent emergency interventions.
• Transplantations (100%), aortic dissections (81.5%), and thoracic aortic aneurysm repair (30%) were predominantly emergency procedures.
• Emergency surgery for acute coronary ischemia, valvular, and congenital heart disease each accounted for less than 10%.

Conclusions:

• Emergency cardiovascular surgery encompasses a diverse range of pathologies with varying frequencies.
• Certain procedures, like transplantations and aortic dissections, are almost exclusively emergent.
• Accelerated diagnostic pathways are crucial for managing hemodynamically unstable patients in emergency cardiovascular surgery.