Management Of Severe Vasoplegia Following Redo Aortic Root And Arch Reconstruction
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.
Al-Attar N, Navas Blanco J. Management of severe vasoplegia following redo aortic root and arch reconstruction. Presented at: American Society of Anesthesiology Annual Meeting; 2022 Oct 21-25; New Orleans, LA.