title: Thoracic and thoracoabdominal aortic repair under regional spinal cord hypothermia.
abstract: OBJECTIVE
  Spinal cord deficits are devastating complications after surgery for thoracic and thoracoabdominal aortic aneurysms. We developed a regional spinal cord cooling system using an epidural catheter containing cold saline within an isolated counter-current lumen to prevent such complications and reviewed the clinical results.
  
  
  METHODS
  We enrolled 37 patients with thoracic (n = 13) and thoracoabdominal (n = 24) aortic aneurysms that were repaired using the regional spinal cord cooling system under mild hypothermia with a partial femoro-femoral bypass.
  
  
  RESULTS
  Although 2 patients died before hospital discharge (hospital mortality, 5.4%), none developed neurological deficits such as paraplegia or paraparesis.
  
  
  CONCLUSIONS
  The outcomes of surgery for thoracic and thoracoabdominal aortic aneurysms under regional spinal cord hypothermia using a custom-designed epidural catheter were excellent. Although our patient cohort was small, the results indicate that our technique might help to improve the outcomes of thoracic and thoracoabdominal aortic repair.
authors: Department of Cardiovascular Surgery, Keio University, Tokyo, Japan shimizu.md@gmail.com.
authors: Hideyuki
authors: H
authors: Shimizu
authors: Department of Cardiovascular Surgery, Kawasaki Municipal Hospital, Kanagawa, Japan.
authors: Atsuo
authors: A
authors: Mori
authors: Department of Cardiovascular Surgery, Keio University, Tokyo, Japan.
authors: Akihiro
authors: A
authors: Yoshitake
authors: Department of Anesthesiology, Keio University, Tokyo, Japan.
authors: Tatsuya
authors: T
authors: Yamada
authors: Department of Anesthesiology, Keio University, Tokyo, Japan.
authors: Hiroshi
authors: H
authors: Morisaki
authors: Department of Physiology, Keio University, Tokyo, Japan.
authors: Hideyuki
authors: H
authors: Okano
authors: Department of Cardiovascular Surgery, Keio University, Tokyo, Japan.
authors: Ryohei
authors: R
authors: Yozu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D002404:Catheterization / Q000379:methods; D004824:Epidural Space; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D007431:Intraoperative Complications / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D010264:Paraplegia / Q000517:prevention & control*; D011183:Postoperative Complications / Q000517:prevention & control; D020760:Spinal Cord Ischemia / Q000517:prevention & control*; D055815:Young Adult
keywords: Aneurysm; Aortic operation; Cardiopulmonary bypass; Surgery techniques