Mrs Samantha Fox is a 75-year-old woman admitted to a private hospital following a visit to her local GP. She has a one month history of fatigue, abdominal and back pain unrelieved by non steroidal anti inflammatory medication. Routine X-ray showed a 4cm infrarenal silhouette and calcification in the wall of the abdominal aorta. Samantha has smoked for the last 50 years 1pack / day. She does not exercise due to pain in her feet. Her meals are delivered to her by meals on wheels. Her past medical history includes type II diabetes, hypertension and peripheral vascular disease. She weighs 86 kgs and 162 cm tall.
BP 155/90, random blood glucose 9.6 mmol/L.
Family history includes: father died of MI aged 49, mother died at aged 79 from sudden death unsure of cause.
Biochemistry Results: Reference Range:
Fasting Glucose 7.8 mmol/L (3.9–6.4)
Cholesterol 8.1 mmol/L (desired < 5.2)
Triglycerides 3.2 g/L (0.4–1.5)
HDL 0.79 mmol/L (0.80–2.05)
LDL 5.3 mmol/L (1.55–4.65)
Current medications
metformin
lisinopril
Frusemide
metoprolol
She has been referred to the dietician and diabetic educator for comprehensive education.
The vascular surgeon who wants do an elective percutaneous repair of infrarenal abdominal aortic aneurysm.
Following the repair of her aortic aneurysm with a Gore bifurcated Excluder endograft she is cared for in the ICU. During her ICU stay her ECG, CVP, arterial pressure and urine output is monitored continuously.
Discuss the pathophysiological development of aortic aneurysms. Compare and contrast the use of percutaneous interventions for the repair of AAA’s and examine the potential complications following the procedure.