RT Book, Section
A1 Wasnick, John D.
A1 Nicoara, Alina
SR Print(0)
ID 1166980893
T1 Anesthesia for Repair of Diseases of Thoracic Aorta
T2 Cardiac Anesthesia and Transesophageal Echocardiography, 2e
YR 2019
FD 2019
PB McGraw-Hill Education
PP New York, NY
SN 9780071847339
LK accessanesthesiology.mhmedical.com/content.aspx?aid=1166980893
RD 2024/04/20
AB With  each  heartbeat,  blood  is  ejected  into  the  aorta  generating  multiple  mechanical  forces  including  pressure,  radial  stress  and  longitudinal  stress.  These  forces  increase  aortic  wall  tension  potentially  leading  to  the  development  of  aortic  dissections  and  aortic  aneurysms  that  may  require  surgical  or  endovascular  repair.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  (Figure  9–1).Diseases  that  interfere  with  the  delivery  of  blood  to  the  tissues  (e.g.,  aortic  dissections,  atherosclerosis,  and  emboli)  place  patients  at  great  risk  for  organ  ischemia.  Other  disease  conditions  (e.g.,  aneurysms)  weaken  the  wall  of  the  aorta  and  often  result  in  aortic  rupture  and  sudden  death.  Many  patients  with  aortic  disease  present  emergently  secondary  to  acute  dissection,  aneurysm  rupture,  or  following  traumatic  aortic  injury.  Others,  with  long-standing  aortic  aneurysms,  present  for  elective  surgical  or,  increasingly  common,  for  endovascular  repair.