Intensive Care Management of Thoracic Aortic Surgical Patients, Including Thoracic and Infradiaphragmatic Endovascular Repair (EVAR/TEVAR)

Semin Cardiothorac Vasc Anesth. 2015 Dec;19(4):331-41. doi: 10.1177/1089253215613791.

Abstract

The patient with thoracic aortic disease can present for open or endovascular repair. Thoracic endovascular aortic repair (TEVAR) has emerged as a minimally invasive option for a multitude of aortic pathology, including dissections, aneurysms, traumatic injuries, and ulcers. Postoperative management of these patients depends on the extent of procedure, whether it was open or endovascular, and, finally, on the preoperative comorbidities present. While procedural success has catapulted TEVAR to popularity, midterm results have been mixed. Additionally, periprocedural complications such as paraplegia and renal failure remain a significant morbidity in these patients.

Keywords: aortic arch atheroma; cardiac anesthesia; cerebrospinal fluid; neurologic complications; neurological monitoring.

MeSH terms

  • Aorta, Thoracic / pathology
  • Aorta, Thoracic / surgery*
  • Aortic Diseases / pathology
  • Aortic Diseases / surgery*
  • Critical Care / methods
  • Endovascular Procedures / methods*
  • Humans
  • Minimally Invasive Surgical Procedures / methods
  • Postoperative Care / methods
  • Postoperative Complications / epidemiology