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What are the risks of having surgery on a broken bone in foot, when I ahve aortic aneurism?

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What are the risks of having surgery on a broken bone in my foot when a have an aortic aneurism?
Posted Sat, 28 Sep 2013 in Hypertension and Heart Disease
Answered by Dr. Sukhvinder Singh 39 minutes later
Brief Answer:
Please provide details.

Detailed Answer:
Respected Ma'm
Before I go into detailed discussion on topic, I would like to get more information on the aortic aneurysm. This will help me in understanding the risk and reasons better.
1. What is the site (location) and size of aneurysm? Is there any known cause for aneurysm formation like marfan's disease, bicuspid aortic valve etc.
2. Does the patient has any symptoms/ trouble associated with this aneurysm.
3. Please do mention all associated medical illnesses including diabetes, high blood pressure, kidney disease, anginal heart disease, stroke etc.
I am waiting for your reply.
Sukhvinder XXXXXXX
Above answer was peer-reviewed by
Follow-up: What are the risks of having surgery on a broken bone in foot, when I ahve aortic aneurism? 23 hours later
In answer to your questions; the site of the aneurysm is the ascending aorta and its size is 4.4. I have not been told of any cause for the aneurysm. I am symptom free and the aneurysm was found during a pulminary CATScan. I have no associated medical illness. I do have high cholesterol. I also have one kindney as a result of renal cell carsenoma.
Answered by Dr. Sukhvinder Singh 1 hour later
Brief Answer:
Incidence of complication is low at this size.

Detailed Answer:
Respected Ma'm
1. The risk of cardiac events during surgery is not primarily governed by aortic aneurysm. That risk assessment involves assessment of any heart failure, severe valve disease, severe rhythm disorder of heart, presence of diabetes, presence of acute anginal attack, history of stroke, kidney disease etc. We will not discuss that part of risk and that will be calculated by your anesthesiologist after a detailed review.
2. An aortic aneurysm theoretically can have two bad events during peri-operative period. These are a rupture of aneurysm and formation of a fresh thrombus into the aneurysm due to increased thrombogenicity. However the incidence of these events is low. Moreover an aneurysm of size 4.4 cms is not likely to rupture as compared to one more than 5.5-6 cm when risk is relatively high. Moreover the risk of rupture is directly related to increase in heart rate and blood pressure which are easily controllable parameters if your anesthesiologist is alert enough. Risk of new thrombus formation can not be predicted by any means as yet.
3. I am not able to give you the exact incidence for thoracic aneurysm (ascending aorta) as literature is scarce on this topic. However in a relatively small study the incidence of perioperative rupture of abdominal aneurysm was 3 in 45 patients, that too at 20th day, 21st and 71st day. All these aneurysms were more than 5 cm in size. The last two patient survived first surgery and the ruptured occurred during second surgery on long term follow up.
Hence overall the complication rate is small at a size of 4.4 cm.
Hope this helps.
Feel free to discuss further.
Above answer was peer-reviewed by
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