Anaesthetic management in endovascular total aortic arch repair via needle-based in situ fenestration: a case series of 14 patients
Objective Endovascular total aortic arch repair (ETAAR) via needle-based in situ fenestration (ISF) is a major challenge for anaesthesiologists because of haemodynamic instability and the risk of cerebral hypoxia. We herein summarise our experience with anaesthetic management of patients who underwe...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2020-10-01
|
| Series: | Journal of International Medical Research |
| Online Access: | https://doi.org/10.1177/0300060519893517 |
| _version_ | 1818983269428887552 |
|---|---|
| author | Kui-Rong Wang Min Gao Xiao-Hong Wen Hai-Ying Kong |
| author_facet | Kui-Rong Wang Min Gao Xiao-Hong Wen Hai-Ying Kong |
| author_sort | Kui-Rong Wang |
| collection | DOAJ |
| description | Objective Endovascular total aortic arch repair (ETAAR) via needle-based in situ fenestration (ISF) is a major challenge for anaesthesiologists because of haemodynamic instability and the risk of cerebral hypoxia. We herein summarise our experience with anaesthetic management of patients who underwent this procedure. Methods Fourteen patients who underwent ETAAR via ISF for arch pathologies involving the major supra-arch branches were included. Regional cerebral oxygen saturation was measured to monitor cerebral perfusion. Partial extracorporeal circulation (EC) support from the right common femoral vein to the right axillary artery was introduced to provide cerebral perfusion. Results During ISF, vessel rupture occurred in three patients and ventricular fibrillation occurred in one patient. The regional cerebral oxygen saturation significantly decreased during the potential risk period for cerebral ischaemia. Establishment of EC effectively prevented cerebral ischaemia. Conclusions During ETAAR, the risks of haemodynamic instability caused by the procedure and vessel rupture during ISF need to be overcome. Partial EC ensured good cerebral protection in our study, and regional cerebral oxygen saturation monitoring may help to reduce the rate of desaturation. |
| first_indexed | 2024-12-20T18:00:26Z |
| format | Article |
| id | doaj.art-89832413f85d41068567745d02825f68 |
| institution | Directory Open Access Journal |
| issn | 1473-2300 |
| language | English |
| last_indexed | 2024-12-20T18:00:26Z |
| publishDate | 2020-10-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of International Medical Research |
| spelling | doaj.art-89832413f85d41068567745d02825f682022-12-21T19:30:39ZengSAGE PublishingJournal of International Medical Research1473-23002020-10-014810.1177/0300060519893517Anaesthetic management in endovascular total aortic arch repair via needle-based in situ fenestration: a case series of 14 patientsKui-Rong WangMin GaoXiao-Hong WenHai-Ying KongObjective Endovascular total aortic arch repair (ETAAR) via needle-based in situ fenestration (ISF) is a major challenge for anaesthesiologists because of haemodynamic instability and the risk of cerebral hypoxia. We herein summarise our experience with anaesthetic management of patients who underwent this procedure. Methods Fourteen patients who underwent ETAAR via ISF for arch pathologies involving the major supra-arch branches were included. Regional cerebral oxygen saturation was measured to monitor cerebral perfusion. Partial extracorporeal circulation (EC) support from the right common femoral vein to the right axillary artery was introduced to provide cerebral perfusion. Results During ISF, vessel rupture occurred in three patients and ventricular fibrillation occurred in one patient. The regional cerebral oxygen saturation significantly decreased during the potential risk period for cerebral ischaemia. Establishment of EC effectively prevented cerebral ischaemia. Conclusions During ETAAR, the risks of haemodynamic instability caused by the procedure and vessel rupture during ISF need to be overcome. Partial EC ensured good cerebral protection in our study, and regional cerebral oxygen saturation monitoring may help to reduce the rate of desaturation.https://doi.org/10.1177/0300060519893517 |
| spellingShingle | Kui-Rong Wang Min Gao Xiao-Hong Wen Hai-Ying Kong Anaesthetic management in endovascular total aortic arch repair via needle-based in situ fenestration: a case series of 14 patients Journal of International Medical Research |
| title | Anaesthetic management in endovascular total aortic arch repair via needle-based in situ fenestration: a case series of 14 patients |
| title_full | Anaesthetic management in endovascular total aortic arch repair via needle-based in situ fenestration: a case series of 14 patients |
| title_fullStr | Anaesthetic management in endovascular total aortic arch repair via needle-based in situ fenestration: a case series of 14 patients |
| title_full_unstemmed | Anaesthetic management in endovascular total aortic arch repair via needle-based in situ fenestration: a case series of 14 patients |
| title_short | Anaesthetic management in endovascular total aortic arch repair via needle-based in situ fenestration: a case series of 14 patients |
| title_sort | anaesthetic management in endovascular total aortic arch repair via needle based in situ fenestration a case series of 14 patients |
| url | https://doi.org/10.1177/0300060519893517 |
| work_keys_str_mv | AT kuirongwang anaestheticmanagementinendovasculartotalaorticarchrepairvianeedlebasedinsitufenestrationacaseseriesof14patients AT mingao anaestheticmanagementinendovasculartotalaorticarchrepairvianeedlebasedinsitufenestrationacaseseriesof14patients AT xiaohongwen anaestheticmanagementinendovasculartotalaorticarchrepairvianeedlebasedinsitufenestrationacaseseriesof14patients AT haiyingkong anaestheticmanagementinendovasculartotalaorticarchrepairvianeedlebasedinsitufenestrationacaseseriesof14patients |