Anesthetic Induction Strategy for a Patient with a Giant Aortic Arch Aneurysm Compressing the Main Airway: A Case Report

Isolated aortic arch aneurysms are relatively rare, accounting for 21.3% of thoracic aortic aneurysms. However, with an aging population and advancements in imaging technology, the detection rate of aortic arch aneurysms has gradually increased. Key risk factors include age, gender, hypertension, atherosclerosis, hereditary connective tissue disorders, and infections. A giant aortic arch aneurysm is not only a “ticking time bomb” within the patient but also poses significant challenges for anesthesiologists when associated with airway compression, which can lead to airway and circulatory collapse during induction. We report a case of a 52-year-old male who presented with chest pain; imaging revealed a giant aortic arch aneurysm compressing the main airway. The patient underwent total aortic arch replacement under general anesthesia, with a successful surgery. We share this case to discuss the anesthetic induction process and insights for managing aortic arch aneurysms with airway compression.