The anaesthetic management of patients with thoracic ascending aortic aneurysms: A review

Abstract

<jats:p> Thoracic aortic aneurysms present significant challenges to clinicians, especially due to their complex nature and an evolving understanding of the safest and most effective ways to manage this condition in the perioperative setting. Thoracic aortic aneurysms have a prevalence rate of 1.3–8.9% in men and 1.0–2.2% in women, and they are estimated to affect more than five per 100,000 person-years. This is notable because the complications of thoracic aortic aneurysms can be catastrophic. The current understanding of the optimal intraoperative management of thoracic aortic aneurysms is changing, as more evidence becomes available regarding lung protective ventilation and its role in enhancing patient safety and wellbeing. This review strives to provide a brief historical understanding of thoracic aortic aneurysms and highlight some of the key discoveries and advances in the management of this condition. This review then describes an overview of the general anaesthetic principles associated with thoracic aortic aneurysms, including ventilatory modalities and how these impact a patient’s physiology and intraoperative haemodynamics. A brief discussion on one-lung ventilation is then provided, drawing from current literature in the field, to describe the most up-to-date management of thoracic aortic aneurysms. </jats:p>

Uncorrected Preoperative Infection Causing the Death of a Patient with a Thoracic Aortic Aneurysm

“…TAAs have a higher prevalence rate of 1.3–8.9% in men than 1.0–2.2% in women. 1 And approximately 5–10 people out of 100,000 individuals are diagnosed with a TAA every year, representing a major cause of mortality and morbidity in Western countries. 1 The etiology of aneurysmal formation is still not well-understood.…”

“… 1 And approximately 5–10 people out of 100,000 individuals are diagnosed with a TAA every year, representing a major cause of mortality and morbidity in Western countries. 1 The etiology of aneurysmal formation is still not well-understood. Most aortic aneurysms are caused by degenerative, infectious, or genetic conditions that weaken the aortic wall.…”