Aortic Brief History of Acute Essay

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"Valve sparing root replacements may be performed to replace the entire ascending aorta without leaving residual dissection behind" (Type A, 2011, Columbia Surgery). For type B, the usual prescription is blood pressure control, given the risks of surgery. However, endovascular stent grafting is often offered as an alternative and less invasive treatment (Type B, 2011, Columbia Surgery).

When operating, the femoral artery is usually selected for aortic cannulation. But in some patients, "although the femoral artery seems to be intact, its use for aortic return carries a high risk of cerebral embolism because of the atheromatous changes in the thoracic aorta. Alternatively, surgeons may use the axillary artery in the presence of peripheral artery disease or femoral artery dissection" although "the use of the axillary artery for cannulation can be troublesome because of the vessel's small diameter" (Yamamoto et al. 2001).

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Aortic cannulation through the apex of the left ventricle and the aortic valve is recommended as the safest place of entry (Yamamoto et al. 2001).

"Perioperative risk in patients with aortic stenosis depends on the interaction of factors such as the severity of valve disease, concomitant coronary artery disease, and the severity and/or urgency of the surgical procedures" (Christ 2004). Nurses must, in conjunction with the patient's treatment team, evaluate such risk factors and create a prescription both for caring for the stresses that are the immediate results of the surgery and also establish a new routine designed to minimize the patient's coronary risks in the future......

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