TY  - CHAP
M1  - Book, Section
TI  - Chapter 9. Anesthesia for Repair of Diseases of Thoracic Aorta
A1  - Wasnick, John D.
A1  - Hillel, Zak
A1  - Kramer, David
A1  - Littwin, Sanford
A1  - Nicoara, Alina
PY  - 2011
T2  - Cardiac Anesthesia and Transesophageal Echocardiography
AB  - With  each  heartbeat  blood  is  ejected  into  the  aorta  exerting  multiple  mechanical  forces  on  it:  pressure,  radial  and  longitudinal  stress,  tension.  Just  as  diseases  of  the  aorta  can  affect  the  heart,  diseases  of  the  heart  can  affect  the  aorta.  Cardiac  patients  often  suffer  from  both  and  this  makes  their  clinical  care  more  complex.The  aorta  ascends  in  the  anterior  mediastinum,  curves  backward  into  the  aortic  arch  from  which  emanate  the  great  vessels  of  the  head  and  the  upper  extremities,  descends  into  the  posterior  mediastinum  and  beyond  the  diaphragm  continues  into  the  abdomen  providing  blood  to  the  spinal  cord,  gut,  kidneys,  ultimately  dividing  to  deliver  blood  to  the  lower  extremities.  Diseases  that  interfere  with  the  delivery  of  blood  to  the  tissues  (eg,  aortic  dissections,  atherosclerosis,  and  emboli)  place  patients  at  great  risk  for  organ  ischemia.  Other  disease  conditions  (eg,  aneurysms)  weaken  the  wall  of  the  aorta  and  often  result  in  aortic  rupture  and  sudden  death.  Many  patients  with  aortic  disease  present  emergently  in  the  setting  of  acute  aortic  dissection,  contained  aneurysmal  rupture,  or  following  blunt  or  penetrating  traumatic  aortic  injury.  Others,  with  long-standing  aortic  aneurysms,  present  for  elective  surgery  for  repair  of  progressive  dilatation  of  the  thoracic  aorta.  Irrespective  of  the  nature  of  their  thoracic  aorta  disease  these  patients  are  often  quite  unstable  and  their  prognosis  can  be  disappointing.  Consequently,  cardiac  surgeons  and  their  anesthesia  colleagues  are  called  upon  to  exert  great  skill  to  manage  these  "high-risk"  patients.  
SN  - 
PB  - The McGraw-Hill Companies
CY  - New York, NY
Y2  - 2024/04/20
UR  - accessanesthesiology.mhmedical.com/content.aspx?aid=8550964
ER  -