Elective abdominal aortic aneurysm repair
Abdominal aortic aneurysm (AAA) is a localized widening of the lumen of the vessel wall, the greatest risk of which is rupture. For this reason, regular check-ups of patients diagnosed with AAA are appropriate to prevent this acute, life-threatening condition. AAA surgery is considered to be one of the most demanding procedures in vascular surgery, so proper preparation and caution during the procedure as well as in postoperative care is in place
Review
This education material is very well worked out. Each step of the algorithm is correctly, clearly, and accurately explained, including the right and wrong answers. Explanations are well-defined in the interactive algorithm's Czech and English versions.
Sources
MICHÁLEK, Pavel, Michael STERN a Petr ŠTÁDLER. Anestezie a pooperační péče v cévní chirurgii. Praha: Galén, c2012. ISBN 978-80-7262-891-9. WANHAINEN, Anders, Fabio VERZINI, Isabelle VAN HERZEELE, et al. Editor's Choice – European Society for Vascular Surgery (ESVS) 2019 Clinical Practice Guidelines on the Management of Abdominal Aorto-iliac Artery Aneurysms. European Journal of Vascular and Endovascular Surgery [online]. 2019, 57(1), 8-93 [cit. 2022-04-03]. ISSN 10785884. Available from: doi:10.1016/j.ejvs.2018.09.020 PARUK, Fathima a Julian M. CHAUSSE. Monitoring the post surgery inflammatory host response. Journal of Emergency and Critical Care Medicine [online]. 2019, 3, 47-47 [cit. 2022-04-03]. ISSN 25213563. Available from: doi:10.21037/jeccm.2019.08.06 RELJA, Borna a Walter Gottlieb LAND. Damage-associated molecular patterns in trauma. European Journal of Trauma and Emergency Surgery [online]. 2020, 46(4), 751-775 [cit. 2022-04-03]. ISSN 1863-9933. Available from: doi:10.1007/s00068-019-01235-w
Learning targets
2. The student can calculate and interpret Glasgow Aneurysm Score.
3. The student has an overview of hemodynamic changes arising in connection with aortic clamp manipulation.
4. The student has awareness about perioperative management required for the AAA surgery.
Key points
2. Increased preload and afterload can overwhelm the heart after aortic clamping.
3. Due to ischemic changes below the level of the aortic clamp, excessive amounts of lactate are formed in the tissues, which causes metabolic acidosis.
