[Transluminal placed endovascular graft (TPEG) for thoracic aortic disease in fifteen patients under general anesthesia].

ABSTRACT

In 15 transluminal placed endovascular graft (TPEG) operations for thoracic aortic aneurysm either from dissection or injury, we induced general anesthesia with propofol, and maintained with propofol or sevoflurane in nitrous oxide and oxygen. The temporary balloon occlusion technique used for prevention of stent migration caused hypotension (systolic pressure 30-60 mmHg) in all cases. After releasing the occluding balloon, blood pressure in each patient recovered to the prehypotension level without use of catecholamine. We experienced two emergency operations, a thoracotomy and a celiotomy, resulting from graft failure. We had sudden hypotension in two other cases. In the first patient with aortic regurgitation, coronary air embolism was suspected because of ST segment elevation, while in the other, the hypotension was due to unexpected bleeding from the femoral artery sheath. Two additional patients developed vascular injuries occurring during manipulation of the catheter or sheath. In order to manage anesthesia for TPEG, it is necessary to be aware of its complications.