الفهرس 
Applied anatomy of the aortaOnly 14 pages are availabe for public view
 |  | from | 162 |  |  |
| | | from | 162 | | |
Abstract
Summary
Understanding the anatomical basis of the disease process of aorta is the
primary step and essential for the anesthesiologists involved in the care of ortic surgical patients.
The clinical progress of patients with Aortic diseases is unpredictable.
A high level of suspicion is required for early diagnosis and crucial for patient urvival.
The indications of surgery include:
Aortic dissections.
Intra mural hematoma.
Penetrating Aortic ulcer
Aortic aneurysm
Coarctation of the aorta.
Traumatic disruption of aorta.
Other inflammatory and infection.
The American College of Cardiology (ACC) and the American Heart
Association (AHA) have published guidelines for preoperative evaluation. As
applied to aortic surgeries, the guideline effectively consists of four steps to
consider the urgency of the operation, the presence of an acute cardiac
condition, the patient’s functional capacity, and comorbidities.
High-risk aortic surgical procedure in patients with significant
comorbidities increases the perioperative risk. Preoperative estimation of risk
for cardiac, pulmonary, neurologic, and renal systems followed by medical
optimization of the organ function is essential.
The repair of aortic disease can be very complex with significant risk to
the patient even in the event of a seemingly successful repair. This warrants rank discussion with the patient’s family. ue to the complexity of the arterial repair work combined with the omplexity of the CPB arrangements, a thorough understanding of the natomy is necessary to adequately prepare for the anesthetic planning. he complexity of the perfusion system, especially if cerebral
protection is being used, must be understood. Extreme vigilance is necessary o ensure that the patient is protected at all costs.
Management of the patient’s hemodynamic status can be very tenuous
and unstable. All necessary medications should be ready for use prior to
starting the procedure to facilitate rapid response to instability.
Monitoring and protection of organ function (e.g., myocardial,
cerebral, spinal, and renal) are integral aspects of successful aortic surgery.Postoperative care of these patients are, consequently, to minimize the isk of potentially severe complications by maintaining the following:
• Serial clinical examination and high clinical index of
suspicion of potential complications in relation to the aortic
aneurysm disease (ascending, arch, descending, and
thoracoabdominal).
• Adequate cardiac index (CI) and well-controlled. Blood Messure.
• Monitoring for cardiovascular and neurological parameters.
• Adequate oxygenation and respiratory function.
• Attention to hemostatic function.
• Adequate urine output.
• Adequate analgesia