Immediate ICU Care for Patients Following Aortic Arch Surgery

Abstract

Patients undergoing aortic arch surgery are at high risk for stroke, delirium, low cardiac output, respiratory failure, renal failure, and coagulopathy. A significantly higher mortality is seen in patients experiencing any of these complications when compared with those without complications. As surgical, perfusion, and anesthetic techniques improve, the incidence of major complications have decreased. A recent paradigm shift in cardiac surgery has focused on rapid postoperative recovery, and a similar change has affected the care of patients after arch surgery. Nevertheless, a small subset of patients experience significant morbidity and mortality after aortic arch surgery, and rapid identification of any organ dysfunction and appropriate supportive care is critical in these patients. In this article, the current state of postoperative care of the patient after open aortic arch surgery will be reviewed.

Improvement of Clinical Outcomes of Total Aortic Arch Replacement and Frozen Elephant Trunk Surgery With Aortic Balloon Occlusion

“…Its use consistently shortened the lower body CA time and raised the target nadir temperature, improving organ protection during the operation. Due to the complexity of postoperative complications, multi-system real-time surveillance is required during the ICU stay (8). This study investigated the effects of the ABO technique on the clinical outcomes, through continuous monitoring of patients' blood examination results during the in-hospital stay.…”

Early Results of a Novel Single-Stage Hybrid Aortic Arch Replacement Technique to Reduce Bypass and Circulatory Arrest Duration

“…Methods to mitigate circulatory and neurological complications (eg, circulatory arrest, cooling to 18°C, and antegrade selective cerebral perfusion) have had favorable adoption [Panos 2006;Leshnower 2010Leshnower , 2013Roselli 2010;Urbanski 2012;Pacini 2014;Angeloni 2015;Li 2016]. As such, several operative strategies, perioperative techniques, and postoperative management protocols are well described to offset morbidity and mortality [Szeto 2009;Wylie 1979;Zierer 2012;Quintana 2016;Mavroudis 2012;Di Luozzo 2012;Bavaria 1997;Wilkey 2016;Mosca 2016;Hlaing 2016;Chen 2016]. Furthermore, the advent of thoracic endovascular aortic repair (TEVAR) has resulted in favorable treatment options in aortic pathology for high-risk patients and those with prohibitive risk for open procedures [Szeto 2009;Vallabhajosyula 2013a, b;Bavaria 2002].…”