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Technical and clinical aspects of surgery for thoracoabdominal aneurysms 

Technical and clinical aspects of surgery for thoracoabdominal aneurysms
Chapter:
Technical and clinical aspects of surgery for thoracoabdominal aneurysms
Author(s):

Roberto Chiesa

, Efrem Civilini

, Enrico Maria Marone

, Germano Melissano

, and Yamume Tshomba

DOI:
10.1093/med/9780199658220.003.0063
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date: 18 September 2019

Conventional treatment of thoracoabdominal aortic aneurysms consists of graft replacement with reattachment of the main aortic branches. To improve mortality and morbidity rates, a multimodal approach has gradually evolved to reduce the trauma of surgery by maximizing organ protection. Strategies and intraoperative techniques to organ protection include the transperitoneal approach with diaphragm-sparing incision, distal aortic perfusion with a left heart bypass and centrifugal pump, selective intercostal artery reattachment, and optimal perfusion of the visceral vessels. The use and indications of new branched endografts and hybrid surgery are also discussed.

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