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Anaesthetic problems in cross clamping of the thoracic aorta
1Shackleton Department of Anaesthetics, Southampton General Hospital.
Insights
Anesthetic management for descending thoracic aorta cross-clamping is crucial for suprarenal aneurysm repair. Careful monitoring and interventions are vital to mitigate risks like hemodynamic changes and organ damage during this complex surgery.
Area of Science:
- Cardiovascular Surgery
- Anesthesiology
- Vascular Surgery
Background:
- Descending thoracic aorta cross-clamping is essential for specific aortic surgeries.
- This procedure carries significant risks including hemodynamic instability and organ damage.
Purpose of the Study:
- To describe the anesthetic management for nine patients undergoing descending thoracic aorta cross-clamping.
- To present surgical outcomes and discuss methods to mitigate procedural complications.
Main Methods:
- Review of anesthetic management in nine patients undergoing descending thoracic aorta cross-clamping.
- Presentation of surgical results and discussion of complications and their management.
Main Results:
- The study details the anesthetic approach for patients with suprarenal aneurysms or aortic occlusive disease.
- Hemodynamic changes during aortic clamping and declamping were observed.
- Potential complications such as myocardial infarction, ventricular failure, renal dysfunction, and massive blood transfusion requirements were noted.
Conclusions:
- Anesthetic management is critical for patients undergoing descending thoracic aorta cross-clamping.
- Proactive measures are necessary to manage hemodynamic shifts and protect vital organs.
- Further strategies are needed to address challenges like renal preservation and massive transfusion.
Abstract:
Cross clamping of the descending thoracic aorta is performed in this hospital for graft replacement of suprarenal aneurysms or during endarterectomy for extensive aortic occlusive disease. The anaesthetic management of nine patients is described and the surgical results are presented. Proximal aortic clamping and declamping lead to profound haemodynamic changes. Myocardial infarction, ventricular failure and even death may result. Renal preservation during clamping and massive blood transfusion are also problems of this surgical approach. The measures taken to ameliorate the consequences of proximal aortic clamping are discussed in detail.