test 6 indications for surgery

Question 1

INDICATIONS FOR SURGERY – ASCENDING AORTA: dissection

Answer 1

 Acute Type A
 Virulent Course
 High Mortality

Question 2

INDICATIONS FOR SURGERY – ASCENDING AORTA: Aneurysm

Answer 2

 Persistent pain despite small aneurysm
 AV Involvement creating MI
 Angina
 Rapidly expanding
 Greater than 5-5.5 cm diameter

Question 3

INDICATIONS FOR SURGERY – AORTIC ARCH: dissections

Answer 3

 Acute, limited to arch (rare)

Question 4

INDICATIONS FOR SURGERY – AORTIC ARCH: Aneurysm

Answer 4

 Repair of arch aneurysm is more complicated
 Carries increased morbidity and mortality
 Persistent symptoms
 Greater than 5.5-6cm
 Progressive expansion

Question 5

INDICATIONS FOR SURGERY – DESCENDING AORTA: Dissection

Answer 5

 Medical management in acute phase
 Failure to control hypertension medically
 Continued pain
 Enlargement on CXR, CT, Angio
 Neurologic deficit
 Renal/ GI Ischemia

Question 6

INDICATIONS FOR SURGERY – DESCENDING AORTA: aneurysm

Answer 6

 Greater than 5-6cm
 Expanding
 Leaking
 Chronic, causing persistent pain.

Question 7

AORTIC SURGERY Considerations

Answer 7

 Where is the aneurysm located?
 Where do we need to cannulate?
 Do we need to circ arrest?
 Median sternotomy versus Thoracotomy?
 Full CPB or Left heart bypass?