Regional hypothermia with epidural cooling for prevention of spinal cord ischemic complications after thoracoabdominal aortic surgery.
Multiple operative adjuncts have been developed and clinically applied to reduce the incidence of spinal cord ischemic complications (SCI) after thoracoabdominal aneurysm (TAA) repair. Hypothermia is known to reduce oxygen requirements in central nervous tissue and has been successfully applied in the arena of central cardioaortic surgery. Based on our experimental and clinical results, we have employed regional hypothermia by epidural cooling to ameliorate SCI during TAA repair in over 300 patients. This review describes the results obtained in our experience using an approach to TAA repair whereupon the spinal cord is protected during surgery by regional hypothermia via epidural cooling.
Black
James H
JH
Division of Vascular and Endovascular Surgery and the Thoracic Aortic Center, Harvard Medical School, Boston, MA 02114, USA.
Davison
J Kenneth
JK
Cambria
Richard P
RP
D017544:Aortic Aneurysm, Abdominal / Q000453:epidemiology / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000453:epidemiology / Q000601:surgery*; D004824:Epidural Space / Q000601:surgery; D006801:Humans; D007036:Hypothermia, Induced; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*; D012307:Risk Factors; D020760:Spinal Cord Ischemia / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*