TEVAR can be used to treat fusiform and saccular descending thoracic aortic aneurysms (DTAAs), acute and chronic type B aortic dissection (TBAD) and blunt thoracic aortic injury. Here, we discuss key perioperative management principles for the care of TEVAR patients, focusing on immediate postoperative management. Nonetheless, significant morbidity and mortality can result from the procedure itself and patient comorbidities. Thoracic endovascular aortic repair (TEVAR) is less physiologically demanding on patients than conventional open surgical repair. Video Perioperative management of patients undergoing thoracic endovascular repair. Achieving optimal results after TEVAR requires attention to detail across the preoperative, intraoperative and postoperative phases of care. The better the care team understands the expected postoperative course, the earlier that deviations can be recognized and the more likely that successful rescue can be achieved to reduce the incidence and severity of adverse outcomes. These principles focus on the transition between the operating room and the intensive care unit, prevention and management of spinal cord deficits (SCD), and vital neurological, respiratory, cardiovascular, renal, gastrointestinal and hematological concerns. In this article, we discuss fundamentals for managing patients after endovascular aortic aneurysm repair. Maximizing the likelihood of a successful outcome requires diligent multidisciplinary (surgical, critical care, nursing, pharmacy, nutrition and physical therapy) perioperative care. Thoracic endovascular aortic repair (TEVAR) is a less invasive method for treating thoracic and some thoracoabdominal aortic aneurysms, dissections of the thoracic aorta and blunt traumatic aortic injury, compared with conventional open surgery.
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December 2022
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