Management Of Severe Vasoplegia Following Redo Aortic Root And Arch Reconstruction

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Conference Proceeding

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A 60-year-old male with a history of a Type A aortic dissection status-post repair and AVR for severe AI was found to have an enlarging aortic root and distal ascending aorta/proximal arch. Decision was made to perform a re-do Bentall Procedure. Given complex anatomy, the patient had a CPB time of 9 hours and DHCA time of 100 minutes. Upon coming off bypass, the patient experienced severe vasoplegia. Thromboelastographic-guided resuscitation was performed and additional vasoplegic therapy was administered, improving his SVR. The patient eventually recovered after a prolonged ICU stay. We discuss the pathophysiology and management strategies for severe vasoplegia.


American Society of Anesthesiology Annual Meeting, New Orleans, LA, October 21-25, 2022.