What kind or preparation is relevant for a thoracoabdominal aneurysm repair?

What kind of preparation is relevant for a thoracobdominal aneurysm repair? Again, the workup needs to be very meticulous. So open thoracobdomal repair is a very invasive procedure and requires a high degree of skill and expertise from the operating surgeon and is usually performed in a tertiary referral center with a history of success with those operations. The additional investigations one might want to obtain because the aneurysm supplies the, you know, aneurysm usually involves the territory of the aorta that supplies the kidneys and the gut. In addition to all the cardiac and lung function workup, you'd want to obtain data on the kidney function, the split kidney function, usually using a MAG3 scan which tells us how much of the overall function is supplied by each side. So, for example, split 50-50 or 60-40 and that that helps to inform decisions you know if it's a tricky aneurysm you know if we're going to salvage a single renal you know kidney artery which ones are going to be for example. So again so for work up the thoracic abdominal you know aneurysms you need to work up the patient physiologically in as much detail, if not more, for an infernal repair. And also any kind of pre-existing cardiac problems, for example, if they've got a, you know, if they've got a, say, a left main stem coronary stenosis that is causing angina, you'd want to optimise that first before undertaking a big repair like that. Again, again, even for the endovascular repair, which usually involves fenestrated or branched technology, you really need to undertake a close investigation of the patient's fitness, again with the same sort of investigations. Additionally, the analysis of the anatomy has to be really particular is undertaken on a 3D workstation because the stent grafts that are designed for those types of repairs are based on the patient's unique anatomy. So you send off the results of that analysis and then the device company analyses the anatomy themselves and then everyone comes together with a custom stent which is approved by both parties for that particular patient. So for endovascular repair attention to detail with the anatomy is really important.