AI Scribe for Vascular Surgeons

OPERATIVE REPORT

PATIENT: 68-year-old male
DATE OF SURGERY: [Date]
SURGEON: [Surgeon Name], MD
ASSISTANT: [Assistant Name], MD
ANESTHESIA: General endotracheal anesthesia

PRE-OPERATIVE DIAGNOSIS:
6.2 cm infrarenal abdominal aortic aneurysm

POST-OPERATIVE DIAGNOSIS:
6.2 cm infrarenal abdominal aortic aneurysm

PROCEDURE PERFORMED:
Endovascular abdominal aortic aneurysm repair (EVAR)

INDICATIONS:
68-year-old male with asymptomatic 6.2 cm infrarenal AAA discovered on screening ultrasound. CT angiogram demonstrates favorable anatomy for endovascular repair: infrarenal neck 22mm length, 25mm diameter, minimal angulation. Common iliac arteries patent and adequate for landing zones. Patient counseled on open vs endovascular options. Risks including endoleak, graft migration, limb occlusion, renal injury, rupture, and need for reintervention discussed. Patient elects EVAR.

PRE-OPERATIVE IMAGING:
CTA abdomen/pelvis:
- Aneurysm maximum diameter: 6.2 cm
- Proximal neck: 25mm diameter, 22mm length, <60° angulation
- Distal landing zones: Right CIA 18mm, Left CIA 17mm
- Access vessels: Bilateral CFA adequate (8mm)

FLUOROSCOPY TIME: 18.4 minutes
CONTRAST VOLUME: 110 mL Isovue-370

PROCEDURE DETAILS:
Patient positioned supine. Bilateral groins prepped and draped in sterile fashion.

Bilateral femoral artery access:
Right CFA: 18F sheath placed via percutaneous access
Left CFA: 12F sheath placed via percutaneous access

Calibrated pigtail catheter advanced to L1 level for aortogram. Confirmed anatomy and measured landing zones. Renal arteries marked.

Main body device deployment (Right side):
- Cook Zenith bifurcated endograft main body
- 28mm x 118mm (proximal diameter x length)
- Deployed with bottom of graft 15mm below lowest renal artery
- Proximal fixation with suprarenal stent
- Short limb to right CIA

Contralateral limb cannulation and deployment (Left side):
- 16mm x 120mm iliac limb extension
- Deployed into left CIA with 20mm overlap with main body
- Good seal confirmed

Right iliac extension:
- 16mm x 80mm iliac limb extension
- Extended to right CIA
- Proximal overlap with short limb

Angioplasty:
- Balloon angioplasty of main body with 28mm x 40mm Coda balloon
- Angioplasty of bilateral limb overlap zones with 16mm balloon
- Molding of proximal seal zone

Completion angiography:
- Widely patent graft with no kinking
- Brisk flow to bilateral CIA, EIA, IIA
- No endoleak visualized (Type I, II, or III)
- Both renal arteries patent
- Aneurysm sac excluded

Sheaths removed. Bilateral femoral arteries closed with Perclose ProGlide devices (pre-deployed). Hemostasis achieved. Distal pulses palpable bilaterally.

DEVICES IMPLANTED:
- Cook Zenith main body 28-118 (Lot #[number])
- Cook Zenith left iliac limb 16-120 (Lot #[number])
- Cook Zenith right iliac limb 16-80 (Lot #[number])

ESTIMATED BLOOD LOSS: <100 mL
COMPLICATIONS: None

DISPOSITION:
Patient tolerated procedure well and transferred to PACU in stable condition. Groin sites soft with palpable DP/PT pulses bilaterally. Post-operative CTA scheduled in 30 days for surveillance. Long-term imaging surveillance per EVAR protocol. Aspirin 81mg daily continued.