title: Cardiopulmonary exercise testing in the pre-operative assessment of patients for repair of abdominal aortic aneurysm.
abstract: We have investigated the value of cardiopulmonary exercise testing in the pre-operative assessment to patients for abdominal aortic aneurysm repair. Thirty-six patients were entered into the study. All had a pre-operative clinical assessment and investigations including chest radiograph, electrocardiograph, spirometry and echocardiogram with measurement of left ventricular ejection fraction. Each patient performed a symptom limited treadmill exercise test using a STEEP protocol with on-line measurement of respiratory gas exchange. Patients were followed up for 12 months post-operatively by review of casenotes. Thirty out of 36 patients had surgical repair of abdominal aortic aneurysm. There was 1 death in the perioperative period and 2 deaths in the following 12 months. Seven other patients suffered post-operative complications. There were no significant differences in left ventricular ejection fraction, spirometry and peak achieved oxygen consumption (PVO2) between those patients who died or who had post-operative complications and those who had not. However, PVO2 < 20 ml/min/kg was found in 70 per cent of patients who had complications compared with 50 per cent of those who had not. Also 4 patients considered medically unfit for surgery all had PVO2 < 20 ml/min/kg. Cardiopulmonary exercise testing with measurement of PVO2 may be helpful in identifying patients more at risk of post-operative complications but should not be used in isolation without through clinical assessment.
authors.affiliation: Department of Respiratory Medicine, Belfast City Hospital, Northern Ireland.
authors.forename: A M
authors.initials: AM
authors.lastname: Nugent
authors.forename: M
authors.initials: M
authors.lastname: Riley
authors.forename: J
authors.initials: J
authors.lastname: Megarry
authors.forename: M J
authors.initials: MJ
authors.lastname: O'Reilly
authors.forename: J
authors.initials: J
authors.lastname: MacMahon
authors.forename: R
authors.initials: R
authors.lastname: Lowry
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D005080:Exercise Test; D005260:Female; D006321:Heart / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D011300:Preoperative Care; D011659:Pulmonary Gas Exchange; D012119:Respiration