Skip Navigation

Continuing Education in Anaesthesia, Critical Care & Pain 2006 6(2):54-59; doi:10.1093/bjaceaccp/mkl002
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by Puchakayala, M. R.
Right arrow Articles by Lau, W. C
Right arrow Search for Related Content
PubMed
Right arrow Articles by Puchakayala, M. R.
Right arrow Articles by Lau, W. C
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?


Continuing Education in Anaesthesia, Critical Care & Pain | Volume 6 Number 2 2006 © The Board of Management and Trustees of the British Journal of Anaesthesia [2006]. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Descending thoracic aortic aneurysms

Madhusudan Rao Puchakayala, MB BS, MD, FRCA
Consultant Cardiac Anaesthetist, Guy's and St Thomas' NHS Foundation Trust, Lambeth Palace Road, London SE1 7EH, UK Tel: 0207 188 0652 Fax: 0207 188 0628 E-mail: madhusudan.puchakayala@gstt.nhs.uk (for correspondence)

Wei C Lau, MD
Associate Professor and Director of Cardiac Anaesthesia, Department of Anaesthesiology, University of Michigan Medical Center 1500 East Medical Center Drive, Ann Arbor, MI 48109-0048, USA
The first 150 words of the full text of this article appear below.


Key points

The natural course of the majority of aortic aneurysms is rupture and death.

Patients usually have co-morbidities involving the heart, lung and kidneys: these must be identified and optimized appropriately.

Surgical access is best achieved by a left thoracotomy and using one lung ventilation.

Distal perfusion techniques reduce the incidence of complications.

After operation, the mean arterial pressure should be maintained between 80 and 100 mm Hg to prevent spinal cord hypoperfusion.

The main postoperative complications are renal failure and ischaemic spinal cord injury.

 

The incidence of thoracic aortic aneurysms is estimated to be 5.9 compared with 350 cases for abdominal aortic aneurysms per 100 000 person-years. Of the thoracic aortic aneurysms, the ascending aorta is affected in 50% of cases, the aortic arch in 10% and the descending thoracic aorta (DTA) in 40%.1 A DTA aneurysm is defined as involving any portion of the thoracic aorta distal . . . [Full Text of this Article]


   Preoperative investigations
 

   Intraoperative management
 
Haemodynamic monitoring

Patient positioning

One lung ventilation

Surgical technique

Pathophysiology of aortic cross-clamp

Pharmacological management of the period of aortic cross-clamping

Proximal and distal aortic perfusion management

End-organ assessment and protection

Renal

Spinal cord

Mesentery

Massive blood loss and coagulopathy

Management of anaesthesia


   Postoperative management
 

Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?