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Anesthetic Management of Thoraco-Abdominal Open Procedures

The Mount Sinai Experience

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Thoraco-Abdominal Aorta

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Abstract

Surgical repair of thoraco-abdominal aortic aneurysms is a technically demanding procedure which often mandates the participation of very experienced anesthetists, surgeons, and intensivists. Its complexity resides not only in challenging surgical aspects such as the need for interrupting the natural cerebral perfusion, but also in the requirement for meticulous monitoring strategies during the perioperative period. In order to coordinate and establish an advanced aortic program, Randall B. Griepp joined Mount Sinai in 1985. His incorporation to the hospital brought the subsequent introduction of several institutional changes, including the use of deep hypothermic circulatory arrest and selective antegrade cerebral perfusion, the application of neuroprotection methods, the creation of an aortic surveillance program, and the establishment of an aortic clinic with a focus on personalized anesthetic treatment for each patient. Additionally, Griepp built a productive animal research laboratory to develop new strategies for spinal cord protection. In this chapter, we aim to detail our tailored anesthetic approach to patients undergoing thoracoabdominal aortic aneurysm repair, based on our 25-year clinical and research experience.

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Author information

Authors and Affiliations

  1. Department of Anesthesiology, The Mount Sinai School of Medicine, New York, NY, USA

    Javier G. Castillo, George Silvay & Gregory W. Fischer

Authors
  1. Javier G. Castillo
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  2. George Silvay
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  3. Gregory W. Fischer
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Editor information

Editors and Affiliations

  1. Department of Vascular Surgery, “Vita-Salute” University, IRCCS H., San Raffaele, Milan, Italy

    Roberto Chiesa , Germano Melissano  & Alberto Zangrillo ,  & 

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Castillo, J.G., Silvay, G., Fischer, G.W. (2011). Anesthetic Management of Thoraco-Abdominal Open Procedures. In: Chiesa, R., Melissano, G., Zangrillo, A. (eds) Thoraco-Abdominal Aorta. Springer, Milano. https://doi.org/10.1007/978-88-470-1857-0_21

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  • DOI: https://doi.org/10.1007/978-88-470-1857-0_21

  • Publisher Name: Springer, Milano

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