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Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
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Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
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Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
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Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
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A nurse managing a patient with aortic regurgitation begins with a comprehensive assessment, including a review of the patient's medical history, family history, and lifestyle factors. During the cardiac examination, the nurse listens for heart sounds and checks for signs of valve abnormalities. The nurse also observes for symptoms such as dyspnea, orthopnea, and paroxysmal nocturnal dyspnea and assesses the patient's endurance and daily activity tolerance.Based on the findings, the nurse...
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Shared decision-making and specific informed consent in patients with aortic aneurysms.

Marcela Juliano Silva Cunha1, Marcelo Passos Teivelis1, Cynthia de Almeida Mendes1

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Approximately 26% of asymptomatic patients with aortic aneurysms refused elective surgery after a detailed informed consent process. Smaller aneurysm size was the primary factor influencing this decision, despite being above the recommended surgical threshold.

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Area of Science:

  • Vascular Surgery
  • Patient Decision-Making
  • Health Outcomes

Background:

  • Elective surgical repair is indicated for asymptomatic aortic aneurysms to prevent rupture.
  • Patient understanding and consent are crucial for treatment adherence.
  • Shared decision-making aims to align patient preferences with clinical recommendations.

Purpose of the Study:

  • To determine the refusal rate of elective aortic aneurysm surgery in asymptomatic patients.
  • To analyze factors influencing patient decisions after a comprehensive informed consent process.

Main Methods:

  • Retrospective analysis of 49 patients offered elective aortic aneurysm surgery.
  • Patients were divided into groups based on acceptance or refusal of surgery.
  • Informed consent involved a detailed form and a family meeting.

Main Results:

  • 13 out of 49 patients (26.5%) refused surgery.
  • Patients who refused surgery had statistically smaller aneurysms (9% vs. 26%).
  • Aneurysm size was the only significant factor influencing refusal.

Conclusions:

  • A significant proportion of patients refuse elective aortic aneurysm repair even when indicated.
  • Smaller aneurysm size, though above indication thresholds, is associated with higher refusal rates.
  • Shared decision-making highlights patient autonomy but reveals complexities in accepting prophylactic surgery.