What investigations will be done preoperatively?

Investigations for our patients are very much dependent on the medical history that they present with. If you have lots of heart problems, cardiovascular problems, we may send you for further investigations associated with your heart. If you have diseases of the lungs like COPD or asthma, we may be concerned about your lungs and therefore send you for lung function tests. Generally on the whole we send everybody for a set of blood tests which include knowing what your haemoglobin is, that is how much blood is going around your circuit, what your clotting profile is, how well your blood will clot, especially if you're taking medication that will affect that clotting. We like to know how much your kidney is functioning and what the normal kind of electrolytes, which are things like sodium and potassium, calcium and other magnesium and other sort of electrolytes in your bloodstream, what their baseline levels are. This helps us manage you on the day of surgery and throughout will stay and also helps us make decisions about whether there are things that we need to optimize before you come to us in surgery. All of these investigations are very much dependent on your health but there are some surgeries like aortic aneurysm surgery where we will do a comprehensive set of tests which include an echocardiogram, an ultrasound of the heart showing us how the heart is functioning, what the valves are doing, the valves within your heart and how well your heart pumps. We will do a lung function test which will look exactly at how well your lungs function, how much oxygen goes in and out and how well you are able to breathe in and out based on particularly patients who have had smoking history or long-standing lung disease. These investigations very much make up how we make a decision and which decision we make in which way to operate and so if you're having aortic surgery, if you have poor lung function tests and a heart that we are concerned about, we may then decide if it is a viable option that we will go down the stent route rather than the open aortic replacement route.