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Anesthesiology pp 615-624 | Cite as

Anesthesia for Open AAA

  • Jimmy C. Yao
  • Milad Sharifpour
Chapter

Abstract

Abdominal aortic aneurysms (AAA) affect approximately 9% of men and 2% of women, with a strong predilection in adults >65 years old and smokers. The mortality of ruptured AAA approaches 90% and it is the 15th leading cause of death in adults 60 years and older. Endovascular aneurysm repair has quickly replaced open repair for infra-renal AAA, accounting for over 80% of all AAA repairs in the US. Compared to endovascular treatment options, open repair remains the definitive treatment, with proven long-term risk reduction of aneurysm rupture. Careful preoperative optimization is required to reduce perioperative morbidity and mortality. Special attention is given to pre-existing cardiovascular, renal, pulmonary, and neurologic co-morbidities. Invasive cardiovascular monitoring and large bore intravenous access are required in anticipation of rapid hemodynamic shifts during the critical stages of aortic clamping and unclamping.

Keywords

Open AAA Abdominal aortic aneurysm Anesthetic considerations Aortic cross clamp Renal protection Spinal cord ischemia Risk factors for AAA 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of AnesthesiologyEmory University School of MedicineAtlantaUSA
  2. 2.Department of AnesthesiologyEmory University Hospital, Emory University School of MedicineAtlantaUSA

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