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Thoracoabdominal aortic aneurysm (TAAA) repair remains one of the most challenging procedures and is associated with high mortality and complication rates. Careful consideration of the surgical strategy is essential, particularly in cases involving extensive replacement and high-risk patients. A 61-year-old man with a 55-mm TAAA was referred for surgical treatment.

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Vasoplegia in Heart, Lung, or Liver Transplantation: A Narrative Review.

J Cardiothorac Vasc Anesth

January 2025

Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, MA.

Vasoplegia is a pathophysiologic state of hypotension in the setting of normal or high cardiac output and low systemic vascular resistance despite euvolemia and high-dose vasoconstrictors. Vasoplegia in heart, lung, or liver transplantation is of particular interest because it is common (approximately 29%, 28%, and 11%, respectively), is associated with adverse outcomes, and because the agents used to treat vasoplegia can affect immunosuppressive and other drug metabolism. This narrative review discusses the pathophysiology, risk factors, and treatment of vasoplegia in patients undergoing heart, lung, and liver transplantation.

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Introduction: To improve surgical quality and safety, health systems must prioritise equitable care for surgical patients. Racialised patients experience worse postoperative outcomes when compared with non-racialised surgical patients in settler colonial nation-states. Identifying preventable adverse outcomes for equity-deserving patient populations is an important starting point to begin to address these gaps in care.

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Objectives: Studies comparing alternative autologous vein grafts (AAVG) to single-segment great saphenous vein (ssGSV) grafts report mixed results. The status of AAVG as first choice when ssGSV is unavailable is not unequivocal, based on current evidence. Our study compares results between AAVG and ssGSV in lower extremity bypass surgery.

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