Anaesthesia for Thoracic Aortic Disease: Series of Four Cases
Correspondence Address :
S Ajanth,
No 230, 7th Block, Mogappair West, JJ Nagar West, Chennai 37, Mumbai, Maharastra, India.
E-mail: ajinves94@gmail.com
Thoracic aortic diseases involving the thoracic aorta, from the ascending aorta, the aortic arch to the descending aorta, can present in the form of aneurysms, dissection, tear and coarctation which usually lead to various complications, requiring surgical intervention. The same can be addressed surgically by ascending aorta replacement or reduction aortoplasty with/without Aortic Valve Replacement (AVR). The anaesthetic implications might vary depending on the pathology of the thoracic aortic disease which can be acute or chronic and, silent or symptomatic. Anaesthetic management of four patients (1 female and 3 males) with varied thoracic aortic diseases have been described in the series, including bicuspid aortic valve with severe aortic stenosis, Ischaemic Heart Disease (IHD) with severe Aortic Regurgitation (AR) with ascending aortic aneurysm, ascending aortic dilatation in a known Takayasu arteritis patient and coarctation of aorta with atrial septal defect. These patients underwent aortoplasty with or without aortic root replacement. Full cardiopulmonary bypass with Deep Hypothermic Circulatory Arrest (DHCA) at 16-20°C was the technique used for these procedures as it prevents stroke and ensures cognitive function. This technique had no additional cannulas, less chances of intimal injury or embolisation and clear surgical fields. During the process of rewarming, Inj. Nitroglycerine was started which reduced preload, conserving the myocardium against ischaemic injuries. These patients were successfully managed perioperatively and were discharged with good outcomes postoperatively.
Aortic aneurysms, Aortic stenosis, Bicuspid aortic valve, Coarctation of aorta
DOI: 10.7860/JCDR/2023/60416.17954
Date of Submission: Sep 23, 2022
Date of Peer Review: Dec 23, 2022
Date of Acceptance: Mar 01, 2023
Date of Publishing: Jun 01, 2023
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Oct 01, 2022
• Manual Googling: Jan 19, 2023
• iThenticate Software: Feb 28, 2023 (11%)
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