Department of Cardiothoracic Vascular Surgery, BLK Superspeciality Hospital, New Delhi, India.
Department of Cardiothoracic Vascular Surgery, BLK Superspeciality Hospital, New Delhi, India.
Ann Thorac Surg. 2019 Dec;108(6):e373-e375. doi: 10.1016/j.athoracsur.2019.04.043. Epub 2019 Jun 1.
Management of ruptured ascending aortic aneurysms causing hemodynamic compromise represents a major challenge, especially during induction of anesthesia. We present a case of ruptured ascending aortic aneurysm with cardiac tamponade and cardiogenic shock, managed by awake cardiopulmonary bypass to avoid hemodynamic collapse. This represents an unconventional approach to establishing cardiopulmonary bypass, which in most cases is done postinduction. Increased surgical bleeding from full heparinization before sternotomy can be a problem, limiting visibility.
处理导致血流动力学不稳定的升主动脉破裂动脉瘤是一项重大挑战，特别是在麻醉诱导期间。我们报告了一例升主动脉破裂伴心脏压塞和心源性休克的病例，通过清醒体外循环管理以避免血流动力学崩溃。这代表了一种建立体外循环的非常规方法，大多数情况下是在诱导后进行。在切开胸骨前充分肝素化会导致手术出血增加，从而限制了术野的可视性。
