Brain and spinal cord protection during aortic surgery.

Area of Science:

• Cardiovascular Surgery
• Aortic Aneurysm Repair
• Thoracic Surgery

Background:

• Descending thoracic and thoracoabdominal aortic aneurysms often present with concurrent aortic arch disease.
• Surgical repair of these complex aneurysms poses significant technical challenges.

Purpose of the Study:

• To evaluate the technical feasibility and outcomes of single-stage open repair for descending thoracic or thoracoabdominal aortic aneurysms with concomitant aortic arch disease.
• To assess the role of specific perfusion and protection strategies in achieving favorable surgical and neurological results.

Main Methods:

• Retrospective review of patients undergoing single-stage open repair.
• Surgical approach via high left thoracotomy or thoracolaparotomy.
• Utilization of distal aortic perfusion and antegrade cerebral perfusion, alongside brain and spinal cord protection strategies.

Main Results:

• Single-stage open repair was found to be technically feasible in the studied patient cohort.
• The employed perfusion and protection techniques appeared to contribute to satisfactory surgical outcomes.
• Adequate neurological outcomes were observed in conjunction with these protective measures.

Conclusions:

• Single-stage open repair is a viable option for complex aortic aneurysms involving the descending thoracic and thoracoabdominal aorta with aortic arch disease.
• Distal aortic perfusion and brain/spinal cord protection strategies are crucial for optimizing surgical and neurological results in these challenging cases.