Profound hypothermia for spinal cord protection in operations on the descending thoracic and thoracoabdominal aorta

Elective hypothermic cardiopulmonary bypass with or without circulatory arrest has been used successfully for the treatment of complex aneurysms of the descending thoracic and thoracoabdominal aorta. Hypothermia has a protective effect on spinal cord function, and its use has been associated with a low incidence of paraplegia in traditionally high-risk patients. In our series, 96 consecutive patients underwent resection and graft replacement of diseased aortic segments of the distal aortic arch, the descending thoracic aorta, or the thoracoabdominal aorta. Thirty-day mortality was 7.3%, and the incidence of spinal cord ischemic injury was 3.4%. Our experience with hypothermic cardiopulmonary bypass and circulatory arrest confirms the safety and efficacy of the technique for operations on the descending thoracic and thoracoabdominal aorta.