Anaesthesia for surgical repair of thoracoabdominal aortic aneurysms.
Thoracoabdominal aortic aneurysms are one of the most challenging surgeries for the anaesthetists. They account for 10% of aneurysms of the aorta. A thorough understanding of pathophysiology, anatomy, and surgical interventions including extracorporeal circulation are essential to achieve a good outcome. Crawford classified them accorting to their their extent and location in 4 types. Patients with Crawford type II aneurysms are at greatest risk for paraplegia and renal failure from ischemia to the spinal cord and kidneys during cross-clamp. Neurologic and renal complications are significant for the most extensive forms of aneurysms. Mortality has improved over time as a consequence of either increased surgical experience, the adoption of a protocolized strategy for repair, or secular improvements in anaesthetic and intensive care treatment. Long-term survival after elective TAAA repair is excellent.
Hashem
M
M
Senior Specialist Registrar, Singleton Hospital, Swansea, UK. mahashem63@hotmail.com
Cinà
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CS
D000758:Anesthesia; D017544:Aortic Aneurysm, Abdominal / Q000145:classification / Q000401:mortality / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000145:classification / Q000401:mortality / Q000601:surgery*; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D011183:Postoperative Complications / Q000517:prevention & control; D011300:Preoperative Care / Q000379:methods