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Thoracic aorta aneurysm open repair in heart transplant recipient; the anesthesiologist's perspective


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

Correspondence Address:
Fabrizio Monaco
Department of Anesthesia and Intensive Care, Vita-Salute San Raffaele University, Via Olgettina 60, Milan, 20132
Italy
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9784.173049

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Year : 2016  |  Volume : 19  |  Issue : 1  |  Page : 201-204

 

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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.






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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

Correspondence Address:
Fabrizio Monaco
Department of Anesthesia and Intensive Care, Vita-Salute San Raffaele University, Via Olgettina 60, Milan, 20132
Italy
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9784.173049

Rights and Permissions

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.






[FULL TEXT] [PDF]*


        
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