Lay summary
The global volume of surgery is on the rise and, while there have been significant advances in perioperative care, surgery remains associated with excess cardiovascular-related mortality and morbidity. Clinically silent myocardial injury (injury in the absence of cardiovascular signs/symptoms) is alarmingly common, is strongly associated with postoperative mortality and can only be detected with a cardiac troponin (cTn) surveillance programme. Patients with peripheral vascular disease undergoing surgery are at high-risk of experiencing this type of myocardial injury postoperatively, but we do not currently operate a cTn surveillance programme in this patient group in Aotearoa New Zealand. Here, we provide a framework for investigating the use of a cTn surveillance programme in vascular surgery, establishing a long-term biobank for monitoring postoperative cardiovascular complications in this patient group and developing a consensus cTn surveillance tool for diagnosing and managing cardiac injury in vascular surgery.