Анестезиологическое обеспечение пациентов с диссекцией аорты типа А

«It is type of surgery that is not for the lone operator… Team is of course essential in the operating theater, where in addition to the surgical and nursing assistants, the anesthesiologist plays a part of fundamental importance which deserves a special tribute.»  Russel C. Brock, 1949 Deep hypothermic circulatory arrest (DHCA) for the adult aortic arch repair is still associated with significant mortality and morbidity. Furthermore, there is significant variation in the conduct of this complex perioperative technique. The variation in the practice of DHCA has not been adequately characterized and may offer multiple therapeutic opportunities for outcome enhancement and reduction of procedural risk. The International Aortic Arch Study Group (IAASSG) was recently organized to investigate an optimal neuroprotection during the thoracic aortic reconstruction.«Этот тип хирургического вмешательства не предназначен для одного хирурга … В операционной важна, несомненно, команда, в которой, помимо ассистентов-хирургов и хирургических сестер, анестезиолог играет основополагающую роль, что заслуживает особой награды.»  Рассел К. Брок, 1949Глубокая гипотермическая остановка кровообращения (ГГОК) для хирургической коррекции дуги аорты у взрослых все еще ассоциируется с высоким уровнем летальности и осложнений. Кроме того, имеются существенные расхождения в выполнении этой сложной периоперативной техники. Вариации в практике ГГОК не были адекватно охарактеризованы и могут предоставить множество терапевтических возможностей для улучшения исхода и снижения риска процедуры. Недавно была создана Международная группа по исследованию дуги аорты, задачей которой является изучение оптимальной нейропротекции во время реконструкции грудного отдела аорты

Perioperative Assessment of Patients With Cardiac Implantable Electronic Devices

Worldwide, nearly 4 million patients currently have cardiac implantable electronic devices. Due to the increasing number of candidates to receive either pacemakers or implantable cardiac defibrillators, there is no doubt that primary care physicians or anesthesiologists are very likely to interact and deal with this particular patient population. However, besides technologic advancements, several factors have been frequently reported to cause confusion regarding their perioperative care. Therefore, it has become extremely valuable to understand the basic functions and operation of these devices, as well as their functional limitations, to prevent iatrogenic complications and detect potential failure in an early stage. Mt Sinai J Med 79:25–33, 2012. © 2012 Mount Sinai School of Medicin

Anesthetic Management of Patients with a Type A Aortic Dissection

«It is type of surgery that is not for the lone operator… Team is of course essential in the operating theater, where in addition to the surgical and nursing assistants, the anesthesiologist plays a part of fundamental importance which deserves a special tribute.»  Russel C. Brock, 1949 Deep hypothermic circulatory arrest (DHCA) for the adult aortic arch repair is still associated with significant mortality and morbidity. Furthermore, there is significant variation in the conduct of this complex perioperative technique. The variation in the practice of DHCA has not been adequately characterized and may offer multiple therapeutic opportunities for outcome enhancement and reduction of procedural risk. The International Aortic Arch Study Group (IAASSG) was recently organized to investigate an optimal neuroprotection during the thoracic aortic reconstruction