High risk endovascular aneurysm repair: a case report

Area of Science:

• Vascular Surgery
• Cardiology
• Pulmonology

Background:

• A 66-year-old male patient with a history of chronic obstructive pulmonary disease (COPD), hypertension, and ischemic heart disease (IHD) presented for elective repair.
• The patient had undergone coronary artery bypass grafting (CABG) eight years prior and maintained an asymptomatic status post-surgery.

Observation:

• Screening identified a 5.5cm abdominal aortic aneurysm (AAA).
• Pre-assessment revealed a reduced forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC) ratio of 48%, indicating significant COPD severity.

Findings:

• The patient was deemed suitable for elective endovascular aneurysm repair (EVAR).
• Management involved careful consideration of his multiple comorbidities, including severe COPD and cardiovascular history.

Implications:

• This case highlights the importance of comprehensive pre-operative assessment in patients with complex comorbidities undergoing EVAR.
• Successful EVAR in patients with significant risk factors necessitates a multidisciplinary approach to optimize outcomes.
• Careful perioperative management is crucial for patients with abdominal aortic aneurysms and coexisting pulmonary and cardiac conditions.