Progress in perioperative management of thoraco-abdominal aortic aneurysm surgery_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

XIE Yan ¹ ,  SONG Yi ¹ ,  GUAN Yulong ²

1. Department of Extracorporeal Circulation, Fuwai Yunnan Cardiovascular Hospital, Kunming, 650102, P. R. China;
2. Department of Extracorporeal Circulation, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100037, P. R. China;

Corresponding author：

SONG Yi, Email: Drsongyi@163.com; GUAN Yulong, Email: guanyulong2014@163.com

Keywords：

Thoraco-abdominal aortic aneurysm; surgery; extracorporeal circulation; spinal cord dysfunction; review

DOI：

10.7507/1007-4848.202302045

Video：

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The surgical treatment of thoraco-abdominal aortic aneurysm is a unique solution completed by multidisciplinary cooperation. Preoperative detailed examination and evaluation should be carried out to determine the appropriate point for surgery and optimize the organ function through necessary means. During perioperative period, excellent surgical skills and appropriate strategy of extracorporeal circulation will be adopted according to the scope of involvement, and necessary measures will be utilized to monitor and protect the functions of vital organs. Close monitoring and management in postoperative stage, early warning of complications and effective treatment are essential ways to improve the prognosis of TAAA surgery. This article reviews the research progress in perioperative management of TAAA surgery.

1.	Kalder J, Kotelis D, Jacobs MJThoracoabdominal aortic aneurysmChirurg2016879797810.
2.	Zafar MA, Chen JF, Wu J, et al. Natural history of descending thoracic and thoracoabdominal aortic aneurysmsJ Thorac Cardiovasc Surg20211612498511.
3.	Chatterjee S, Casar JG, LeMaire SA, et al. Perioperative care after thoracoabdominal aortic aneurysm repair: The Baylor College of Medicine experience. Part 1: Preoperative considerations. J Thorac Cardiovasc Surg, 20211612693698.
4.	Fleisher LA, Fleischmann KE, Auerbach AD, et al. 2014 ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery: A report of the American College of Cardiology/American Heart Association Task Force on practice guidelinesJ Am Coll Cardiol20146422e77137.
5.	Girardi LN, Lau C, Munjal M, et al. Impact of preoperative pulmonary function on outcomes after open repair of descending and thoracoabdominal aortic aneurysmsJ Thorac Cardiovasc Surg20171532S22S29.
6.	Coselli JS, Amarasekara HS, Zhang Q, et al. The impact of preoperative chronic kidney disease on outcomes after Crawford extent Ⅱ thoracoabdominal aortic aneurysm repairsJ Thorac Cardiovasc Surg2018156620532064.
7.	Tan CW, Wall M, Rosengart TK, et al. How to bridge? Management of anticoagulation in patients with mechanical heart valves undergoing noncardiac surgical proceduresJ Thorac Cardiovasc Surg20191581200203.
8.	Kärkkäinen JM, Pather K, Tenorio ER, et al. Should endovascular approach be considered as the first option for thoraco-abdominal aortic aneurysms? J Cardiovasc Surg (Torino), 2019, 60(3): 298-312.
9.	Tanaka A, Oderich GS, Estrera ALTotal abdominal debranching hybrid thoracoabdominal aortic aneurysm repair versus chimneys and snorkelsJTCVS Tech2021102833.
10.	Kouchoukos NT, Kulik A, Haynes M, et al. Early outcomes after thoracoabdominal aortic aneurysm repair with hypothermic circulatory arrestAnn Thorac Surg2019108513381343.
11.	Norton EL, Orelaru F, Ahmad RA, et al. Hypothermic circulatory arrest versus aortic clamping in thoracic and thoracoabdominal aortic aneurysm repairJ Card Surg2022371243514358.
12.	Green SY, Safi HJ, Coselli JSA history of open thoracoabdominal aortic aneurysm repair: perspective from HoustonJ Cardiovasc Surg (Torino)2021623191202.
13.	Tanaka A, Estrera AL, Safi HJOpen thoracoabdominal aortic aneurysm surgery technique: How we do itJ Cardiovasc Surg (Torino)2021624295301.
14.	Lopez-Marco A, Adams B, Oo AYThoracoabdominal aneurysmectomy: Operative steps for Crawford extent II repairJTCVS Tech202032536.
15.	马明星, 常谦, 于存涛, 等外科治疗DeBakeyⅠ型和Ⅲ型夹层合并胸腹主动脉瘤的结果对比中国医学科学院学报2020423319326..
16.	李军, 石佳, 陈雷, 等非体外循环全胸腹主动脉置换术的麻醉处理中华医学杂志2013937528530..
17.	Chatterjee S, Casar JG, LeMaire SA, et al. Perioperative care after thoracoabdominal aortic aneurysm repair: The Baylor College of Medicine experience. Part 2: Postoperative management. J Thorac Cardiovasc Surg, 20211612699705.
18.	Imamura Y, Kin H, Yoshioka K, et al. Thoracoabdominal aortic aneurysm repair based on pre- and postoperative evaluation of the artery of AdamkiewiczEur J Cardiothorac Surg2022625ezac196.
19.	Haunschild J, von Aspern K, Herajärvi J, et al. Impact of distal aortic perfusion on 'segmental steal' depleting spinal cord blood flow-a quantitative experimental approachEur J Cardiothorac Surg2022625ezac213.
20.	Hage A, Bozinovski J, Ouzounian M, et al. Commentary: Expertise in thoracoabdominal aortic aneurysm repair-More than just the knifeJ Thorac Cardiovasc Surg20211612706707.

1. Kalder J, Kotelis D, Jacobs MJThoracoabdominal aortic aneurysmChirurg2016879797810.
2. Zafar MA, Chen JF, Wu J, et al. Natural history of descending thoracic and thoracoabdominal aortic aneurysmsJ Thorac Cardiovasc Surg20211612498511.
3. Chatterjee S, Casar JG, LeMaire SA, et al. Perioperative care after thoracoabdominal aortic aneurysm repair: The Baylor College of Medicine experience. Part 1: Preoperative considerations. J Thorac Cardiovasc Surg, 20211612693698.
4. Fleisher LA, Fleischmann KE, Auerbach AD, et al. 2014 ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery: A report of the American College of Cardiology/American Heart Association Task Force on practice guidelinesJ Am Coll Cardiol20146422e77137.
5. Girardi LN, Lau C, Munjal M, et al. Impact of preoperative pulmonary function on outcomes after open repair of descending and thoracoabdominal aortic aneurysmsJ Thorac Cardiovasc Surg20171532S22S29.
6. Coselli JS, Amarasekara HS, Zhang Q, et al. The impact of preoperative chronic kidney disease on outcomes after Crawford extent Ⅱ thoracoabdominal aortic aneurysm repairsJ Thorac Cardiovasc Surg2018156620532064.
7. Tan CW, Wall M, Rosengart TK, et al. How to bridge? Management of anticoagulation in patients with mechanical heart valves undergoing noncardiac surgical proceduresJ Thorac Cardiovasc Surg20191581200203.
8. Kärkkäinen JM, Pather K, Tenorio ER, et al. Should endovascular approach be considered as the first option for thoraco-abdominal aortic aneurysms? J Cardiovasc Surg (Torino), 2019, 60(3): 298-312.
9. Tanaka A, Oderich GS, Estrera ALTotal abdominal debranching hybrid thoracoabdominal aortic aneurysm repair versus chimneys and snorkelsJTCVS Tech2021102833.
10. Kouchoukos NT, Kulik A, Haynes M, et al. Early outcomes after thoracoabdominal aortic aneurysm repair with hypothermic circulatory arrestAnn Thorac Surg2019108513381343.
11. Norton EL, Orelaru F, Ahmad RA, et al. Hypothermic circulatory arrest versus aortic clamping in thoracic and thoracoabdominal aortic aneurysm repairJ Card Surg2022371243514358.
12. Green SY, Safi HJ, Coselli JSA history of open thoracoabdominal aortic aneurysm repair: perspective from HoustonJ Cardiovasc Surg (Torino)2021623191202.
13. Tanaka A, Estrera AL, Safi HJOpen thoracoabdominal aortic aneurysm surgery technique: How we do itJ Cardiovasc Surg (Torino)2021624295301.
14. Lopez-Marco A, Adams B, Oo AYThoracoabdominal aneurysmectomy: Operative steps for Crawford extent II repairJTCVS Tech202032536.
15. 马明星, 常谦, 于存涛, 等外科治疗DeBakeyⅠ型和Ⅲ型夹层合并胸腹主动脉瘤的结果对比中国医学科学院学报2020423319326..
16. 李军, 石佳, 陈雷, 等非体外循环全胸腹主动脉置换术的麻醉处理中华医学杂志2013937528530..
17. Chatterjee S, Casar JG, LeMaire SA, et al. Perioperative care after thoracoabdominal aortic aneurysm repair: The Baylor College of Medicine experience. Part 2: Postoperative management. J Thorac Cardiovasc Surg, 20211612699705.
18. Imamura Y, Kin H, Yoshioka K, et al. Thoracoabdominal aortic aneurysm repair based on pre- and postoperative evaluation of the artery of AdamkiewiczEur J Cardiothorac Surg2022625ezac196.
19. Haunschild J, von Aspern K, Herajärvi J, et al. Impact of distal aortic perfusion on 'segmental steal' depleting spinal cord blood flow-a quantitative experimental approachEur J Cardiothorac Surg2022625ezac213.
20. Hage A, Bozinovski J, Ouzounian M, et al. Commentary: Expertise in thoracoabdominal aortic aneurysm repair-More than just the knifeJ Thorac Cardiovasc Surg20211612706707.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

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