Safety and efficacy of hypothermic cardiopulmonary bypass and circulatory arrest for operations on the descending thoracic and thoracoabdominal aorta

Unusual case of successful treatment of a ruptured thoracoabdominal aneurysm in elderly woman

“…Several techniques were proposed to decrease the risk of malperfusion, including surgical manoeuvre of two repositioning clamps, systemic hypothermia, cerebrospinal fluid drainage, the irrigation of the epidural space with cold solutions or visceral hybrid procedures [2][3][4][5]. In our case, employing a two-clamp technique was, unfortunately, prevented by the rupture of the aneurysm and a huge haematoma around the aorta in the retroperitoneal space.…”

“…Thus, no time was lost in transferring her to our department and achieving diagnosis. However, especially in older patients, open surgery for ruptured TAAAs is associated with grave prognosis [2,3]. Having this in mind, we initially selected this patient for endovascular treatment with a customized fenestrated stent graft.…”

Contemporary Management of Descending Thoracic and Thoracoabdominal Aortic Aneurysms: Endovascular Versus Open

“…Some centers prefer this modality for its at least theoretical benefit for organ preservation. 33 However, because of the bleeding and pulmonary complications that often accompany this technique, most surgeons believe that it should be utilized when no other technical option exists for repair of TA/TAA. 34 Such circumstances are, in fact, rare in our experience.…”

<![CDATA[<B>Single stage surgical approach for arch and descending thoracic aorta aneurysm</B>]]>

“…When the aneurism does not compromise the aortic arch, large aneurisms can be approached using left thoracotomy or thoracophrenolaparotomy, with similar techniques of protection against spinal cord and cerebral ischemic lesions [4][5][6].…”