Distal Aortic Perfusion and Selective Visceral Perfusion

Incredible progress has been made in the treatment of thoracoabdominal aortic aneurysms since its inception. The various strategies of organ protection including the use of distal aortic perfusion, CSF drainage, visceral perfusion, sequential aortic cross-clamp, intercostal artery reattachment and moderate hypothermia, as well as the evolution of surgical approach have all contributed to the decline in mortality and morbidity. Our refined surgical techniques and use of adjuncts have reduced the overall incidence of neurological deficits following thoracoabdominal aortic aneurysm repair to 2.4%, and to 6.6% for patients with extent II. Our continuing goals are to further decrease the incidence of neurological deficits and to improve renal protection, with particular focus on the extent II thoracoabdominal aortic aneurysm.