The Management of Patients With Acute Aortic Syndrome in A Hospital Setting on the Example of an Emergency Hospital

Abstract

ABSTRACT Today, the issue of the effectiveness of emergency specialized care for patients with acute aortic syndrome (AAS) is extremely relevant in Russian healthcare. Much attention is paid to logistics and management in the AAS. There is a tendency to increase the share of hybrid treatment of aortic pathology due to the rapid development of endovascular technologies in Russian healthcare institutions. This article presents the scheme of logistics at the prehospital stage, perioperative management and options for surgical treatment, including hybrid and endovascular options of AAS. Particular attention is paid to the resolution of the malperfusion syndrome. The main studies were carried out on the basis of SAHI RT Regional Center for Emergency Medical Care.AIM OF STUDY Development of a logistics scheme and tactics for the treatment of patients with acute aortic pathology.MATERIAL AND METHODS This article provides demographic data and incidence statistics. Not only the hospital stage of effective treatment is important, but logistics with routing and anesthesia management as well. Examples of the routing schemes used by us in practice for patients with AAS starting from 2017 are given. Variants of hybrid treatment and resolution of malperfusion syndrome in patients with AAS are shown on the example of clinical cases.CONCLUSION The applied schemes for transporting patients with AAS allowed the optimal treatment strategy to be chosen, where time is of the essence. Proper perioperative management in patients with aortic pathology will allow deaths to be minimized and/or prevented. The options of performed surgical treatment showed a good result, a decrease in mortality. Penn classification, especially in a situation of high perioperative risk, made it possible to predict in-hospital mortality and outcomes of surgical treatment, and also helped choose an adequate treatment strategy

Keywords

• acute aortic syndrome
• aortic pathology
• aortic dissection
• outside and in situ
• fenestration
• ftevar
• tevar
• stent graft