Safety of Perioperative Cerebrospinal Fluid Drain as a Protective Strategy During Descending and Thoracoabdominal Open Aortic Repair

Abstract Objective We present our experience with routine application of CSF drain(CSFD) during open aortic repair. Methods We retrospectively reviewed 100 patients with descending or thoracoabdominal aortic aneurysm (DTAA) who underwent CSFD insertion prior to open repair between 2006 and 2017. All CSFD were inserted by the cardiovascular anesthesia team. The goal was to keep ICP Results Mean patient age was 65.4±11.7, and 60(60%) were male. CSFD was successfully inserted in all patients. Mean hospital stay was 11.9±11.8 days and hospital mortality was 6%. Postoperative transient paresis was observed in 4 patients (4%), and permanent paraplegia in 2(2%). CSFD related complications were reported in 14 patients (14%). Complications included persistent CSF leakage, blood-tinged CSF with and without intracranial hemorrhage and spinal cutaneous fistula in 7(7%), 9(9%), 1(1%) respectively. Long-term survival was excellent (68.4% at 10 years). Conclusions CSFD is a safe practice when applied routinely as an adjunct strategy to prevent paraplegia when in surgical management of DTAA and TAAA. We feel this contributed to good early and late results.