Surgical Technique for Extent IV Thoraco-Abdominal Aortic Aneurysms Chapter uri icon

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abstract

  • Surgical repair of extent IV thoraco-abdominal aortic aneurysms is usually simple because distal aortic perfusion is in most cases not justified. Since the Adamkiewicz artery is usually located proximal to the upper level of the aneurysm, a beveled proximal anastomosis includes in standard repairs the ostia of the celiac, superior mesenteric, and renal arteries. Direct anastomosis of the left renal artery is performed separately. Devastating complications, mainly related to the duration of digestive, renal, or spinal cord ischemia, are, however, encountered when this technique is not fully mastered. In this chapter our current anesthetic and surgical management for standard and specific cases of extent IV thoraco-abdominal aortic aneurysms is described.

publication date

  • 2011