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Anaesthesia for thoracic aortic surgery 

Anaesthesia for thoracic aortic surgery
Chapter:
Anaesthesia for thoracic aortic surgery
Author(s):

Donna Greenhalgh

DOI:
10.1093/med/9780199653478.003.0022
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date: 15 October 2019

This chapter reviews the diseases of the aorta, anaesthetic management and complications of thoracic aortic surgery. Thoracic aortic surgery covers aortic root replacement to thoracoabdominal aneurysm resection, including dissection and deep hyperthermic circulatory arrest (DHCA). Preoperative and perioperative management is discussed with respect to cerebral and spinal cord protection. The classification and perioperative management of aortic dissections is described plus the use of DHCA in surgery. Pharmacological and physical cerebral protection methods are outlined Anaesthesia for thoracoabdominal aneurysms may not routinely use CPB but left heart bypass may be required. Positioning of patients and cannulation are described. Paraplegia is one of the major causes of morbidity. Renal failure is common, as is coagulopathy and major haemorrhage. The risk factors and preventions are listed. Anaesthesia for thoracic aortic surgery encompasses many areas and the astute practitioner needs to be aware of all aspects of the anatomy, physiology and pharmacology that are involved.

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