Anaesthetic-surgical guide in the treatment of ascending aorta and surgery of the ascending aorta and aortic arch. Consensus document of the Spanish Society of Cardiovascular and Endovascular Surgery and the Sociedad of Anaesthesiology, Resuscitation and Pain Therapy.

Autors de IIS La Fe

• Amparo López Gómez

  Autor

• Francisco José Valera Martínez

  Autor

• Rosario Vicente Guillen

  Autor

Autors aliens a IIS La Fe

• Rodríguez R
• Zebdi N
• Ríos Barrera R
• Forteza A
• Legarra Calderón JJ
• Garrido Martín P
• Hernando B
• Sanjuan A
• González Bardanca S
• Varela Martínez MÁ
• Fernández FE
• Llorens R
• Gómez Felices A
• Aranda Granados PJ
• Sádaba Sagredo R
• Echevarría JR
• Silva Guisasola J

Grups d'Investigació

• Anestesia y Cuidados Críticos

  Investigador Principal

  María Azucena Pajares Moncho

• Regeneración y Trasplante Cardíaco

  

  Leader

  Pilar Sepúlveda Sanchis

Abstract

Aortic pathology is always a challenge for the clinician, and must be diagnosed and treated by a multidisciplinary team due to the technical and technological complexity of the resources used. Ongoing efforts to implement a systematic, protocolized approach involving "Aortic teams" made up of cardiologists, cardiac surgeons, vascular surgeons, anaesthesiologists and radiologists, among others are now leading to improved outcomes. The aim of this consensus document drawn up by the Aortic working groups of the Spanish Society of Anaesthesiology, Resuscitation and Pain Therapy (SEDAR) and the Spanish Society of Thoracic and Cardiovascular Surgery (SECTCV) is to disseminate a set of working protocols. The latest consensus document of the European Association for Cardio-Thoracic Surgery (EACTS) and the European Society for Vascular Surgery (ESVS) define the concept of "AORTIC TEAM"(1). The aortic team should be closely involved from diagnosis to treatment and finally follow-up, and should be formed of cardiac and vascular surgeons working together with anaesthesiologists, cardiologists, radiologists and geneticists. Treatment of aortic pathologies should be centralised in large centres, because this is the only way to effectively understand the natural course of the disease, provide the entire range of treatment options under one umbrella and treat potential complications. A streamlined emergent care pathway (24/7 availability), adequate transportation and transfer capabilities, as well as rapid activation of the multidisciplinary team must be available. In light of the complexity and constant evolution of therapeutic options, we present this first version of the Anaesthesiology and surgical guidelines for surgery of the ascending aorta and aortic arch. Some questions will no doubt remain unanswered, and future versions will include new techniques that, though implemented in some centres, are still not widely recommended.

Copyright © 2021 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

Keywords

• Anesthesic and surgical treatment; Aneurisma de arco y aorta ascendente; Aortic acute syndrome; Ascending and aortic arch aneurysm; Guía práctica; Manejo anestésico-quirúrgico; Practice guideline; Síndrome aórtico agudo