Thoracic Aortic Aneurysm Resection

George Silvay, Jacob Michael Lurie

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review

Abstract

In the United States, thoracic aortic aneurysms affect more than 15,000 people every year, and millions of Americans live with undiagnosed thoracic aortic aneurysms. The management of patients with thoracic aortic aneurysms must involve detailed and clear communication between cardiologists, surgeons, and anesthesiologists. The repairs of thoracic aortic aneurysms are delicate surgeries that require cardiopulmonary bypass, hypothermic circulatory arrest, one-lung ventilation, and other complex techniques and procedures. This chapter presents a surgical case requiring the resection of a thoracic aortic aneurysm in the context of a teenage male with Marfan syndrome. A brief history of thoracic aortic aneurysms is presented, as well as an extensive case management section in which the primary concerns of the surgical procedure are detailed. Surgical considerations are discussed by organ system, as well as important discussions pertaining to proper blood pressure and temperature monitoring, transesophageal echocardiography, intraoperative ventilation settings with one-lung ventilation, and postoperative ventilatory considerations. Subsequently, alternative methods as well as the risks and benefits of the procedure are discussed. The chapter concludes with a presentation of the most up-to-date literature, including information on central nervous system protection and monitoring, a discussion regarding the location of arterial cannulation, and a novel system of classification for acute aortic dissections.

Original languageEnglish
Title of host publicationCohen's Comprehensive Thoracic Anesthesia
PublisherElsevier
Pages557-578
Number of pages22
ISBN (Electronic)9780323713016
ISBN (Print)9780323720915
DOIs
StatePublished - 1 Jan 2021

Keywords

  • Marfan syndrome
  • hypothermic circulatory arrest
  • neuroprotection
  • one-lung ventilation
  • resection
  • thoracic aortic aneurysm

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