Anesthetic Challenges in Managing a Patient With Traumatic Aortic Aneurysm and Dissection for Non-vascular Surgery: A Case Report

TL;DR

This case report details the successful anesthetic management of a young patient with a traumatic aortic aneurysm and dissection who underwent non-vascular surgery.

Contribution

The paper presents a novel case highlighting the challenges and successful strategies in anesthetizing a high-risk patient with complex aortic trauma.

Findings

Combined spinal-epidural anesthesia was successfully used for ORIF in a patient with traumatic aortic aneurysm and dissection.

Meticulous hemodynamic control and monitoring ensured a stable intraoperative course without complications.

Conservative management of the aortic aneurysm and interdisciplinary collaboration led to a successful patient outcome.

Abstract

This case report describes the successful management of a 23-year-old male with traumatic aortic aneurysm and dissection, concomitant with bilateral lower limb fractures, highlighting the complexities and challenges of managing such a patient. The patient presented with extensive trauma, including chest pain, cough, and hoarseness of voice, and was diagnosed with a large fusiform aneurysm and dissection of the aorta. A multidisciplinary approach was adopted, and the patient underwent open reduction and internal fixation (ORIF) under combined spinal-epidural anesthesia. Meticulous hemodynamic control and vigilant monitoring ensured a stable intraoperative course. The aortic aneurysm was managed conservatively, and the patient was closely monitored for complications. This case report emphasizes the importance of interdisciplinary synergy, meticulous planning, and vigilant monitoring in managing high-risk patients and demonstrates the successful implementation of evidence-based practices in mitigating potential risks. The patient's successful outcome highlights the impact of collaboration between anesthesiologists, orthopedic surgeons, cardiovascular surgeons, and intensivists in managing complex and daunting injuries.

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