同时行开放式腹主动脉瘤修复术和冠状动脉旁路移植术患者的麻醉管理：一例报告。
The anesthetic management of a patient undergoing simultaneous open abdominal aortic aneurysm repair and coronary artery bypass grafting: A case report.
机构信息
Department of Anesthesiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
出版信息
Medicine (Baltimore). 2022 Nov 11;101(45):e31485. doi: 10.1097/MD.0000000000031485.
RATIONALE
Surgery for abdominal aortic aneurysm (AAA) and concomitant severe coronary artery disease (CAD) is usually managed in a staged procedure. The anesthesia for concurrent surgery is rare and complex. In this report, we present an unusual case of undergoing simultaneous open abdominal aortic aneurysm (AAA) repair and coronary artery bypass grafting (CABG).
PATIENT CONCERNS
A 70-year-old male AAA patient with concurrent triple-vessel CAD underwent a simultaneous surgery.
DIAGNOSIS
The patient underwent computed tomography angiography (CTA) and coronary angiography. He was diagnosed with AAA and triple-vessel CAD.
INTERVENTIONS
The patient underwent simultaneous surgery.
OUTCOMES
The patient underwent anesthesia and surgery smoothly and was discharged on the 13th postoperative day.
LESSONS
The anesthetic management of simultaneous open abdominal aortic aneurysm repair and coronary artery bypass grafting is rare and complicated. Reasonable operation and anesthesia protocols, close monitoring and management of hemodynamic changes, and appropriate cell salvage and hemostasis measures are of great significance to increase perioperative safety and reduce the risk of postoperative complications.
背景
腹主动脉瘤（AAA）合并严重冠状动脉疾病（CAD）的手术通常分阶段进行。同期手术的麻醉罕见且复杂。在本报告中，我们介绍了一例同时行开放性腹主动脉瘤（AAA）修复和冠状动脉旁路移植术（CABG）的不寻常病例。
患者关注
一名 70 岁男性 AAA 患者合并三血管 CAD，行同期手术。
诊断
患者行计算机断层扫描血管造影（CTA）和冠状动脉造影。诊断为 AAA 和三血管 CAD。
干预措施
患者同期手术。
结果
患者麻醉和手术顺利，术后第 13 天出院。
教训
同时行开放性腹主动脉瘤修复和冠状动脉旁路移植术的麻醉管理罕见且复杂。合理的手术和麻醉方案、密切监测和管理血流动力学变化、以及适当的细胞回收和止血措施对增加围手术期安全性和降低术后并发症风险具有重要意义。
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