title: Thoracic aorta aneurysm open repair in heart transplant recipient; the anesthesiologist's perspective.
abstract: Many years following transplantation, heart transplant recipients may require noncardiac major surgeries. Anesthesia in such patients may be challenging due to physiological and pharmacological problems regarding allograft denervation and difficult immunosuppressive management. Massive hemorrhage, hypoperfusion, renal, respiratory failure, and infections are some of the most frequent complications related to thoracic aorta aneurysm repair. Understanding how to optimize hemodynamic and infectious risks may have a substantial impact on the outcome. This case report aims at discussing risk stratification and anesthetic management of a 54-year-old heart transplant female recipient, affected by Marfan syndrome, undergoing thoracic aorta aneurysm repair.
authors.affiliation: Department of Anesthesia and Intensive Care, Vita-Salute San Raffaele University, San Raffaele Scientific Institute, Milan, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Monaco
authors.forename: Alessandro
authors.initials: A
authors.lastname: Oriani
authors.forename: Monica
authors.initials: M
authors.lastname: De Luca
authors.forename: Elena
authors.initials: E
authors.lastname: Bignami
authors.forename: Alessandra
authors.initials: A
authors.lastname: Sala
authors.forename: Roberto
authors.initials: R
authors.lastname: Chiesa
authors.forename: Germano
authors.initials: G
authors.lastname: Melissano
authors.forename: Alberto
authors.initials: A
authors.lastname: Zangrillo
mesh_terms: D000758:Anesthesia; D017545:Aortic Aneurysm, Thoracic / Q000150:complications / Q000209:etiology / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000379:methods*; D005260:Female; D016027:Heart Transplantation / Q000379:methods*; D006801:Humans; D008382:Marfan Syndrome / Q000150:complications; D008875:Middle Aged; D011183:Postoperative Complications / Q000628:therapy; D018570:Risk Assessment; D016896:Treatment Outcome