Anesthesia Approach in Endovascular Aortic Reconstruction
Funda Gümüş, Adil Polat, Bora Farsak, Ayşin Alagöl
Keywords: Aortic aneurysm; endovascular procedures; anesthesia
Introduction: We have analyzed our initial results of our anesthesia techniques in our new-onset endovascular aortic reconstruction cases. Patients and Methods: The perioperative data of 15 elective and emergent endovascular aortic reconstruction cases that were operated in 2010-2011 were collected in a database. The choice of anesthesia was made by the risk factors, surgical team's preferences, type and location of the aortic pathology and by the predicted operation duration. The data of local and general anesthesia cases were compared. Results: Thirteen (86.7%) cases were male and 2 (13.3%) female. Eleven patients were in ASA Class III. The demographic parameters, ASA classifications, concurrent diseases were similar in both groups. Thirteen (86.7%) cases had infrarenal abdominal aortic aneurysm and 2 (13.3%) had Type III aortic dissection. The diastolic arterial pressures were lower in general anesthesia group in 20th and 40th minutes' measurements just like the mean arterial pressure measurements at the 40th, 100th minutes and during the deployment of the graft. Postoperative mortality occurred in 3 (20.0%) patients and they all had general anesthesia and they were operated on emergency basis. Postoperative morbidity occurred in four patients that had general anesthesia (acute renal failure, multi-organ failure and pneumonia). The other patient had atrial fibrillation on the 1st postoperative day and was converted to sinus rhythm with amiodarone infusion. Conclusion: Edovascular aortic reconstruction procedures can safely be performed with both general and local anesthesia less invasively compared to open surgery. General anesthesia may be preferred for the better hemodynamic control.