Surgical repair of thoracic aortic aneurysm (TAA) is a complex procedure that poses many surgical and anesthetic challenges.
Early diagnosis and elective treatment of TAA is of great importance.
Once the decision for operative repair has been made, the patients are assessed in the thorough preoperative evaluation. Our
institution utilizes a multi- disciplinary approach in a specialized Pre-Anesthetic Clinic (PAC) for day an admission cardiac and
major vascular surgery patients. On the day of surgery, the patient is admitted to the hospital in the PAC.
Anesthetic management: Prior to induction of anesthesia, standard ASA monitoring started and antibiotic prophylaxis is
initiated. Airway management (for descending thoracic aortic aneurysm repair with double lumen tube) and all monitoring
will be described. In addition, we monitoring, if applicable, somatosensory and motor evoked potentials, cerebro-spinal fluid
pressure, spinal cord perfusion pressure and cerebral oxygen saturation. A brain protection strategy for open surgical repairs of
the ascending aorta and/or the aortic arch is an essential component of the operative and anesthetic management. For repair of
descending thoracic/ thoracoabdominal aneurysm the focus is prevention of spinal cord complication � paraplegia. For different
surgical repair is utilized deep hypothermic circulatory arrest, or distal perfusion.
We will present results from our institution, review the risk factor and discussed the complication.
George Silvay was born in Czechoslovakia, where he earned M.D. degree. Following his training in surgery and thoracic surgery, he spent time in Germany and USA as a fellow. In 1970 he started his residency in Department of Anesthesiology, Mount Sinai School of Medicine, where he rose to the academic rank of Professor, until present he is active in cardio-thoracic clinical and research anesthesia. He published as an author or co-author over 120 papers in several languages. He is serving in several Journals in Editorial Board. He organized over 40 international meetings.
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