Why the study?
Open repair of thoracoabdominal aortic aneurysm in patients with severe aorto-iliac occlusive disease is considered to carry an extremely high risk for spinal cord injury.
Open repair of a Crawford type II TAAA in a patient with severe AIOD can be successfully performed without spinal cord injury by using a pre-existing axillo-bifemoral bypass graft for arterial return during partial extracorporeal circulation.
May support distal perfusion and sequential repair in select high-risk TAAA; leaves open confirmation in prospective series.
Open repair of thoracoabdominal aortic aneurysm (TAAA) in a patient with severe aorto-iliac occlusive disease is considered to cause an extremely high risk for spinal cord injury. A 71-year-old man who had previously undergone axillo-bifemoral bypass for aorto-iliac occlusive disease presented with persistent dilation of a TAAA. Using distal perfusion via partial extracorporeal circulation at mild hypothermia, we performed segmental sequential repair of Crawford type II TAAA. Various efforts were made to avoid spinal cord injury and ischemic visceral organ damage. Consequently, the patient completely recovered without any serious complications.
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Tsujimoto et al. (2022) studied this question.
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