Abstract 20935: Improving Spinal Cord Protection During the Frozen Elephant Trunk Technique: Effect of a Dedicated Neuroprotection Protocol

Introduction: The frozen elephant trunk (FET) technique may be complicated by a risk of spinal cord injury (SCI) which has been reported as high as 10%.Precise mechanisms responsible for SCI after FET are still unclear and so the best protection strategy to avoid it. Hypothesis: We aim to review our experience with a specific protocol developed to reduce the risk of SCI during open surgery of the descending aorta applied to patients operated with FET in order to increase spinal cord protection Methods: Spinal cord protection protocol included: 1.Careful preoperative planning to deploy of stent above the level of the 10th thoracic vertebra and preserving the patency of the left subclavian artery; 2.Postoperative management with goal directed therapy aimed to achieve mean systemic blood pressure between 85 and 105 mmHg, cardiac index >2.4 l/min/m2, urine output >1 ml/Kg/min, a base excess of 0±5, a pH>7.3 and haemoglobin level >10 g/dl; 3.Cerebrospinal fluid (CSF) drainage was used in 4 patients (5.8%) only...