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Difficult ventilation in a patient with a giant aortic aneurysm: A challenge for the anesthesiologist


1 Department of Anesthesiology, Hospital Clínic de Barcelona, Barcelona, Catalonia
2 Department of Cardiovascular Surgery, Hospital Clínic de Barcelona, Barcelona, Catalonia

Correspondence Address:
Mar Montane-Muntane
Department of Anesthesiology - Hospital Clinic de Barcelona, 170 Villarroel, 08036 Barcelona
Catalonia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aca.aca_309_20

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Year : 2023  |  Volume : 26  |  Issue : 1  |  Page : 86-89

 

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Patients with Marfan syndrome present anatomic variations that may increase the risk of a difficult airway. Moreover, they can present large aortic aneurysms, which may cause extrinsic airway compression. Therefore, difficult ventilation during general anesthesia poses a challenge in that the anesthesiologist has to promptly make a crucial differential diagnosis. Multidisciplinary preoperative assessment and planning of the airway and ventilation management are of utmost importance in such uncommon and highly complex clinical cases. Fiberoptic bronchoscopy is probably a really useful tool in order to assess the severity and extent of the airway compression, both preoperatively and intraoperatively. We present a clinical case where difficult ventilation occurred immediately after the induction of general anesthesia.






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1 Department of Anesthesiology, Hospital Clínic de Barcelona, Barcelona, Catalonia
2 Department of Cardiovascular Surgery, Hospital Clínic de Barcelona, Barcelona, Catalonia

Correspondence Address:
Mar Montane-Muntane
Department of Anesthesiology - Hospital Clinic de Barcelona, 170 Villarroel, 08036 Barcelona
Catalonia
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aca.aca_309_20

Rights and Permissions

Patients with Marfan syndrome present anatomic variations that may increase the risk of a difficult airway. Moreover, they can present large aortic aneurysms, which may cause extrinsic airway compression. Therefore, difficult ventilation during general anesthesia poses a challenge in that the anesthesiologist has to promptly make a crucial differential diagnosis. Multidisciplinary preoperative assessment and planning of the airway and ventilation management are of utmost importance in such uncommon and highly complex clinical cases. Fiberoptic bronchoscopy is probably a really useful tool in order to assess the severity and extent of the airway compression, both preoperatively and intraoperatively. We present a clinical case where difficult ventilation occurred immediately after the induction of general anesthesia.






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