Fabrizio Monaco1, Alessandro Oriani1, Monica De Luca1, Elena Bignami1, Alessandra Sala2, Roberto Chiesa2, Germano Melissano2, Alberto Zangrillo1
1 Department of Anesthesia and Intensive Care, Vita-Salute San Raffaele University, San Raffaele Scientific Institute, Milan, Italy
2 Division of Vascular Surgery, Vita-Salute San Raffaele University, San Raffaele Scientific Institute, Milan, Italy
Many years following transplantation, heart transplant recipients may require noncardiac major surgeries. Anesthesia in such patients may be challenging due to physiological and pharmacological problems regarding allograft denervation and difficult immunosuppressive management. Massive hemorrhage, hypoperfusion, renal, respiratory failure, and infections are some of the most frequent complications related to thoracic aorta aneurysm repair. Understanding how to optimize hemodynamic and infectious risks may have a substantial impact on the outcome. This case report aims at discussing risk stratification and anesthetic management of a 54-year-old heart transplant female recipient, affected by Marfan syndrome, undergoing thoracic aorta aneurysm repair.
Department of Anesthesia and Intensive Care, Vita-Salute San Raffaele University, Via Olgettina 60, Milan, 20132
Source of Support: None, Conflict of Interest: None
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