Regional hypothermia with epidural cooling for spinal cord protection during thoracoabdominal aneurysm repair.
Several techniques have been developed and clinically applied to reduce the spinal cord ischemia complications that follow thoracoabdominal aortic aneurysm (TAA) repair. Hypothermia as a protective adjunct is a concept that has been used throughout the evolution of cardiac and central aortic surgery. Because experimental regional hypothermic perfusion delivered directly to the epidural or intrathecal space showed protective effects against cord injury, we developed and applied a method for providing regional cord hypothermia with epidural cooling during TAA repair. This review describes the technical considerations with epidural cooling and the clinical results obtained in our experience.
Cambria
R P
RP
The Thoracic Aortic Center and the Department of Surgery and Anesthesia, Harvard Medical School, and the Massachusetts General Hospital, Boston 02114, USA.
Davison
J K
JK
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001014:Aortic Aneurysm / Q000601:surgery*; D004824:Epidural Space; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced; D007431:Intraoperative Complications / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D020760:Spinal Cord Ischemia / Q000517:prevention & control*; D014656:Vascular Surgical Procedures / Q000379:methods