Open Treatments for Thoracoabdominal Aortic Aneurysm Repair
Thoracoabdominal aortic aneurysms (TAAA) represent a unique pathology that is associated with considerable mortality if untreated. While the advent of endovascular technologies has introduced new modalities for consideration, the mainstay of TAAA treatment remains open surgical repair. However, the optimal conduct of open TAAA repair requires careful consideration of patient risk factors and a collaborative team effort to mitigate the risk of perioperative complications. In this article preoperative preparation and operative techniques for open TAAA repair is described. Patients with severe chronic obstructive pulmonary disease, as suggested by a forced expiratory volume in 1 second of less than 0.8 L/min and a partial pressure of carbon dioxide greater than 45 mm Hg, should be evaluated by a pulmonologist and receive bronchodilators as well as pulmonary rehabilitation before repair.