Zhonghua yi xue za zhi · 2013
[Anesthetic management for patients undergoing total thoracoabdominal aorta replacement without cardiopulmonary bypass].
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Li Jun, Shi Jia, Chen Lei, Li Li-huan, Ji Hong-wen
Аннотация
OBJECTIVE: To summarize the experience in anesthetic management for total thoracoabdominal aorta replacement without cardiopulmonary bypass.
METHODS: From October 2009 to September 2010, 10 patients of Fuwai Hospital received off-pump total thoracoabdominal aorta replacement. Of these patients, 5 were subjected to Standford B aortic dissection, 2 were Standford A aortic dissection received total aortic arch replacement combined with transaortic stented graft implantation into the descending aorta.1 were Marfan's syndrome, and 2 were thoracoabdominal aorta. All operations used the technique which preserved blood was transfused back by pump via the femoral artery.
RESULTS: The average surgery time was (7.4 ± 1.2) h and extubation time was (14.1 ± 2.5) h, the descending thoracic aorta cross clamp time was (11.5 ± 3.6) min, the intercostal artery reconstruction time was (16.4 ± 5.5) min, the required amount of blood products was fresh frozen plasma (600.5 ± 542.8) ml, platelet(1.7 ± 0.8) U, red blood cell (4.3 ± 2.4) U, auto blood salvage (465.7 ± 242.3) ml. Three patients occurred atelectasis and one patient occurred sero peritoneum postoperation. All of the 10 patients were discharged from hospital without any neurologic complications.
CONCLUSION: The anesthetic management for total thoracoabdominal aorta replacement without cardiopulmonary bypass is feasible. It can reduce the side effects of deep hypothermia circulatory arrest and had a good effect.
METHODS: From October 2009 to September 2010, 10 patients of Fuwai Hospital received off-pump total thoracoabdominal aorta replacement. Of these patients, 5 were subjected to Standford B aortic dissection, 2 were Standford A aortic dissection received total aortic arch replacement combined with transaortic stented graft implantation into the descending aorta.1 were Marfan's syndrome, and 2 were thoracoabdominal aorta. All operations used the technique which preserved blood was transfused back by pump via the femoral artery.
RESULTS: The average surgery time was (7.4 ± 1.2) h and extubation time was (14.1 ± 2.5) h, the descending thoracic aorta cross clamp time was (11.5 ± 3.6) min, the intercostal artery reconstruction time was (16.4 ± 5.5) min, the required amount of blood products was fresh frozen plasma (600.5 ± 542.8) ml, platelet(1.7 ± 0.8) U, red blood cell (4.3 ± 2.4) U, auto blood salvage (465.7 ± 242.3) ml. Three patients occurred atelectasis and one patient occurred sero peritoneum postoperation. All of the 10 patients were discharged from hospital without any neurologic complications.
CONCLUSION: The anesthetic management for total thoracoabdominal aorta replacement without cardiopulmonary bypass is feasible. It can reduce the side effects of deep hypothermia circulatory arrest and had a good effect.