Spinal cord protection for thoracic aortic surgery.

Spinal cord protection is critical for successful outcomes after descending thoracic and thoracoabdominal aortic aneurysm repair. For descending thoracic aneurysms which end above T9, optimum protection is maintained by distal aortic perfusion via a left atrial to distal arterial bypass circuit with a centrifugal pump. In repairs of extensive thoracoabdominal aneurysms, additional measures are required of extensive thoracoabdominaal aneurysms, additional measures are required including hypothermia, intercostal artery implantation into the graft, and spinal fluid drainage.