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Katz et al. Vessel Plus 2023;7:1 Vessel Plus
DOI: 10.20517/2574-1209.2022.52

Review Open Access

Optimal perioperative care for thoracoabdominal

and descending thoracic aortic aneurysm repair: a
review

1,2
1,2
1,2
Abraham Katz 1,2,# , Orlando R. Suero 2,3,# , Vicente Orozco-Sevilla , Ourania Preventza , Marc R. Moon ,
1,2
Joseph S. Coselli , Subhasis Chatterjee 1,2,4
1
Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030,
USA.
2
The Texas Heart Institute, 6770 Bertner Avenue, Houston, TX 77030, USA.
3
Divisions of Cardiovascular Anesthesia and Critical Care Medicine, Department of Anesthesia, Baylor College of Medicine,
Houston, TX 77030, USA.
4
Division of Acute Care and Trauma Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston,
TX 77030, USA.
#
Authors contributed equally and are considered joint first authors.
Correspondence to: Dr. Subhasis Chatterjee, Baylor College of Medicine, One Baylor Plaza, MS: BCM 390, Houston, TX 77030,
USA. E-mail: subhasis.chatterjee@bcm.edu
How to cite this article: Katz A, Suero OR, Orozco-Sevilla V, Preventza O, Moon MR, Coselli JS, Chatterjee S. Optimal
perioperative care for thoracoabdominal and descending thoracic aortic aneurysm repair: a review. Vessel Plus 2023;7:1.
https://dx.doi.org/10.20517/2574-1209.2022.52
Received: 1 Aug 2022 First Decision: 26 Sep 2022 Revised: 4 Oct 2022 Accepted: 7 Dec 2022 Published: 6 Jan 2023
Academic Editor: Carlos A. Mestres Copy Editor: Fangling Lan Production Editor: Fangling Lan

Abstract
In this review, the authors discuss the perioperative management of patients who undergo thoracoabdominal aortic
aneurysm or descending thoracic aortic aneurysm repair. All major organ systems are potentially vulnerable to
complications from these repairs; meticulous preoperative attention to optimizing relevant comorbidities, diligent
performance of intraoperative anesthetic and surgical techniques, and careful postoperative management are
necessary to maximize the likelihood of successful outcomes. Specific attention should be given to reducing the
risk for spinal cord ischemia and for paraplegia. Of note, renal and respiratory systems are especially vulnerable to
major complications and require a thoughtful multidisciplinary approach. Because preventing complications is the
primary goal of perioperative management, deviations from the normal course must be recognized promptly and
addressed aggressively to reduce the likelihood of major morbidity and death.

© The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0
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