Anesthetic Considerations for Surgery on the Aortic Arch

Abstract

Aortic arch surgery requires meticulous teamwork in the true perioperative sense. Planning and communication at all phases from preoperative evaluation, through intraoperative management, to postoperative care should be well coordinated between surgical, anesthesia, perfusion, and intensive care unit teams. This review discusses intraoperative management from the anesthesiologist's perspective, with particular emphasis on transesophageal echo evaluation and coagulation management.

Keywords: aortic atheromatous disease; blood loss; cardiac anesthesia; cardiac surgery; cardiopulmonary bypass; coagulation; deep hypothermic circulatory arrest; intraoperative transesophageal echocardiography; neuroprotection.