Role of the BioMedicus Pump and Distal Aortic Perfusion in Thoracoabdominal Aortic Aneurysm Repair.

We reviewed the role of the BioMedicus pump in the reduction of neurologic complications following the repair of Type 1 and Type 2 thoracoabdominal aortic aneurysms. Since 1991, we have used several different methods for the repair of thoracoabdominal aortic aneurysms including simple cross-clamping, selective use of the BioMedicus pump, cardiopulmonary bypass with or without profound hypothermia, and most recently, distal aortic perfusion using the BioMedicus pump combined with cerebral spinal fluid drainage. This latter method has been the most promising in rectifying the side effects of aortic clamping and in providing the time necessary for thorough thoracoabdominal aortic aneurysm repair. On our service, the ongoing study of the BioMedicus pump and distal aortic perfusion in conjunction with cerebral spinal fluid drainage has shown that these adjuncts can extend the tolerance of the spinal cord to ischemia and lower the overall rate of neurologic complications for Type 1 and Type 2 thoracoabdominal aortic aneurysm repairs to a rate of 5% (early results) and 3% (late results). We highly recommend distal aortic perfusion using the BioMedicus pump combined with cerebral spinal fluid drainage for thoracoabdominal aortic aneurysm repair.