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The Perioperative Management of Ascending Aortic Dissection.

Publication ,  Journal Article
Gregory, SH; Yalamuri, SM; Bishawi, M; Swaminathan, M
Published in: Anesth Analg
December 2018

Acute aortic syndromes are a distinct group of pathologies involving the wall of the aorta that present acutely and can be potentially fatal unless treated in a timely fashion. The syndrome is dominated by aortic dissections, which comprise ≥95% of all such presentations. Those involving the ascending aorta are particularly lethal and require specific and early surgical treatment compared to dissections involving other parts of the aorta. The surgical repair of an ascending aortic dissection presents multiple challenges to the anesthesiologist. Thoughtful management throughout the perioperative period is critical for minimizing the significant morbidity and mortality associated with this condition. In this narrative review, we provide an overview of the perioperative management of patients presenting for the surgical repair of an ascending aortic dissection. Preoperative discussion focuses on assessment, hemodynamic management, and risk stratification. The intraoperative section includes an overview of anesthetic management, transesophageal echocardiographic assessment, and coagulopathy, as well as surgical considerations that may influence anesthetic management.

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Published In

Anesth Analg

DOI

EISSN

1526-7598

Publication Date

December 2018

Volume

127

Issue

6

Start / End Page

1302 / 1313

Location

United States

Related Subject Headings

  • Spectroscopy, Near-Infrared
  • Perioperative Care
  • Perfusion
  • Intraoperative Neurophysiological Monitoring
  • Intraoperative Care
  • Humans
  • Hemostasis
  • Electroencephalography
  • Cardiac Tamponade
  • Blood Pressure
 

Citation

APA
Chicago
ICMJE
MLA
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Gregory, S. H., Yalamuri, S. M., Bishawi, M., & Swaminathan, M. (2018). The Perioperative Management of Ascending Aortic Dissection. Anesth Analg, 127(6), 1302–1313. https://doi.org/10.1213/ANE.0000000000003747
Gregory, Stephen H., Suraj M. Yalamuri, Muath Bishawi, and Madhav Swaminathan. “The Perioperative Management of Ascending Aortic Dissection.Anesth Analg 127, no. 6 (December 2018): 1302–13. https://doi.org/10.1213/ANE.0000000000003747.
Gregory SH, Yalamuri SM, Bishawi M, Swaminathan M. The Perioperative Management of Ascending Aortic Dissection. Anesth Analg. 2018 Dec;127(6):1302–13.
Gregory, Stephen H., et al. “The Perioperative Management of Ascending Aortic Dissection.Anesth Analg, vol. 127, no. 6, Dec. 2018, pp. 1302–13. Pubmed, doi:10.1213/ANE.0000000000003747.
Gregory SH, Yalamuri SM, Bishawi M, Swaminathan M. The Perioperative Management of Ascending Aortic Dissection. Anesth Analg. 2018 Dec;127(6):1302–1313.

Published In

Anesth Analg

DOI

EISSN

1526-7598

Publication Date

December 2018

Volume

127

Issue

6

Start / End Page

1302 / 1313

Location

United States

Related Subject Headings

  • Spectroscopy, Near-Infrared
  • Perioperative Care
  • Perfusion
  • Intraoperative Neurophysiological Monitoring
  • Intraoperative Care
  • Humans
  • Hemostasis
  • Electroencephalography
  • Cardiac Tamponade
  • Blood Pressure