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RGUHS Nat. J. Pub. Heal. Sci Vol: 14  Issue: 2 eISSN:  pISSN

Review Article

Anaesthesia Considerations for Dissecting ThoracicAortic Aneurysm

Swati Shah

Chief Anaesthesiologist, Asian Heart Institute, Mumbai – 400051, Maharashtra, India

Author for Correspondence :

Swati Shah

Chief Anaesthesiologist, Asian Heart Institute, Mumbai – 400051, Maharashtra, India swati.shah@ahire.com

Received Date: 2017-11-18,
Accepted Date: 2018-12-30,
Published Date: 2018-01-30
Year: 2018, Volume: 8, Issue: 1, Page no. 10-12, DOI: 10.26463/rjms.8_1_10
Views: 618, Downloads: 4
Licensing Information:
CC BY NC 4.0 ICON
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0.
Abstract

Surgical intervention is needed when the diameter of aorta increases more than 4.5 cm. Risk of rupture increases with diameter more than 6.0-6.5 cm. True aneurysm exhibits dilatation of all three layers of the aorta unlike pseudoaneurysm that involves only the adventitia. The risk of rupture is estimated by aortic size index. Dissection is classified as acute, subacute and chronic depending on the duration of the disease. The condition is managed either by open surgery, endovascular aortic repair or medically. Principle for open surgery is resection of the primary intimal tear with reapproximation of the intima and adventitia. Major anesthetic considerations involve the management of blood pressure, monitoring & prevention of vital organs ischemia such as heart, lungs, kidney and central nervous system & control of bleeding.

<p>Surgical intervention is needed when the diameter of aorta increases more than 4.5 cm. Risk of rupture increases with diameter more than 6.0-6.5 cm. True aneurysm exhibits dilatation of all three layers of the aorta unlike pseudoaneurysm that involves only the adventitia. The risk of rupture is estimated by aortic size index. Dissection is classified as acute, subacute and chronic depending on the duration of the disease. The condition is managed either by open surgery, endovascular aortic repair or medically. Principle for open surgery is resection of the primary intimal tear with reapproximation of the intima and adventitia. Major anesthetic considerations involve the management of blood pressure, monitoring &amp; prevention of vital organs ischemia such as heart, lungs, kidney and central nervous system &amp; control of bleeding.</p>
Keywords
Cerebral Perfusion Pressure (CPP), Dissection of Aortic Aneurysm, Hypothermic Circulatory Arrest, Intraoperative Anaesthetic Monitoring
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