Off-pump Handle Full Anesthesia Thoracoabdominal Aortic Replacement Surgery

Objective To summarize the experience in anesthetic management for total thoracoabdominal aorta replacement without cardiopulmonary bypass.Methods From October2009to October2011,12patients of Fuwai Hospital received off-pump total thoracoabdominal aorta replacement. Of these patients,6were subjected to Standford B aortic dissection,2were Standford A aortic dissection received total aortic arch replacement combined with transaortic stented graft implantation into the descending aorta.2were Marfan’s syndrome.and2were thoracoabdominal aorta. All operations used the technique which preserved blood was transfused back by pump via the femoral artery.RESULTS The average surgery time was (9.4±2.2) h, the descending thoracic aorta crossclamp time was (12.1±1.8) min, the intercostal artery reconstruction time was (18.7±3.6) min, the abdominal aorta crossclamp time was (28.5±3.2) min and extubation time was (20.5±5.6) h the required amount of blood products was fresh frozen plasma (28.5±3.2) ml, platelet (1.7±0.6) U, red blood cell (4.3±2.2) U, autoblood salvage(474.5±186.2)ml. Three patients occured atelectasis and one patient occurred seroperitoneum postoperation. All of the12patients were discharged from hospital without any neurologic complications.CONCLUSION The anesthetic management for total thoracoabdominal aortareplacement without cardiopulmonary bypass is feasible. It can reduce the side effects of deep hypothermia circulatory arrest and had a good effect.