Cardiology Letters 2015, 24(3):156-159

Aneuryzma hrudnej aorty: klinické, chirurgické a anestetické hľadisko

Silvay G

Department of Anesthesiology, Division of Cardio-thoracic Anesthesiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA

Surgical repair of thoracic aortic aneurysm (TAA) is a complex procedure that poses many surgical, anesthetic and perioperative challenges. Its complexity resides not only in challenging surgical aspects such as the need for interrupting the cerebral perfusion, but also the requirement for meticulous monitoring strategy during the perioperative period. Aneurysms are usually defined as a localized dilation of an arterial lumen greater than 50% of its normal diameter. The majority of the patients with TAA are asymptomatic at the time of diagnosis. TAA are usually found incidentally after chest X-ray or other imaging studies. Most patients are hypertensive but remain asymptomatic until the aneurysm expands. The main presenting symptom is pain. Pain may be sharp and acute implying impending aortic dissection or rupture. The location of pain may indicate the area of aortic involvement. Early diagnosis and elective treatment of TAA is of great importance. Elective surgeries in specialized institution have the best results. Diagnosis by size and symptoms have recently been enhanced with new "non-size criteria" by evaluation of mechanical properties of the aortic wall, symptomatic athero-embolism and biomarkers. It is important to apply the type of treatment in a timely manner, considering the conservative, radical surgical open resection or placement of endovascular stent.

Kľúčové slová: thoracic aortic aneurysm; pain; surgical treatment

Uverejnené: March 1, 2015  Zobraziť citáciu