Anesthetic Considerations for Endovascular Repair of the Thoracic Aorta

Figures

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  Figure 1.. Various aortic pathologies, including penetrating aortic ulcer, dissection, intramural hematoma, and aneurysm. Used with permission of Baylor College of Medicine.

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  Figure 2.. Landing zones of the thoracic aorta, including zone 0 (aortic root to just beyond the innominate artery), zone 1 (innominate artery to just beyond the left common carotid artery), zone 2 (left common carotid artery to just beyond the left subclavian artery), zone 3 (first two centimeters of the descending aorta distal to the left subclavian artery), and zone 4 (end of zone 3 to mid-descending aorta at approximately T6). The green segments delineate the aortic arch; proximal to the arch is the ascending aorta and distal to the arch is the descending aorta 14 used with permission of Baylor College of Medicine.

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  Figure 3.. (A) Aortic arch and descending aortic aneurysm; (B) Hybrid repair with surgical debranching of the head vessels and antegrade deployment of descending endograft stent; (C) Completed hybrid repair with deployed endograft stent. Used with permission of Baylor College of Medicine.

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  Figure 4.. (A) Descending thoracic aortic aneurysm status post stent graft without coverage of the head vessels; (B) Left common carotid to left subclavian artery bypass graft; (C) Descending thoracic aortic aneurysm status post stent graft with left subclavian artery coverage and left common carotid to left subclavian artery bypass graft. Used with permission of Baylor College of Medicine.

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  Figure 5.. (A) Development of an ascending aortic pseudoaneurysm from a prior cannulation site; (B) Completed repair with endograft stent. Used with permission of Baylor College of Medicine.

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  Figure 6.. Aortic arch branched endovascular stent grafts. Left, Nexus Aortic Arch Stent Graft System with integrated innominate artery branch by Endospan (image courtesy of Endospan). Right, TAG Thoracic Branch Endoprosthesis with left subclavian artery branch by Gore (image courtesy of Gore Medical).