Electrophysiologic monitoring during surgery to repair the thoracoabdominal aorta

The repair of aneurysms and dissections that involve the thoracoabdominal aorta represent a major stress to the cardiovascular surgery team because of the feared complication of paraplegia. Here, the etiology of this complication is explained through a description of the relevant surgical anatomy and characteristics of hemodynamic support. In addition, recent advances in the neurophysiologic assessment of the descending motor pathways and their application to perioperative monitoring are discussed.