Repair of thoracoabdominal aortic aneurysms is one of the most challenging problems in cardiovascular surgery, as surgeons undertaking these operations are faced with the risks of substantial mortality and devastating complications, such as ischemic spinal cord injury resulting in paraplegia. While solutions to these problems remain far from complete, considerable progress has been made over the past decade by groups incorporating techniques originally developed by E. Stanley Crawford and associates at Baylor College of Medicine, Houston, Tex.1 The results reported by Svensson et al are evidence of this, with an 8% operative mortality rate and a 3.8% incidence of permanent spinal cord complications in a series of 132 patients. Thoughtful review of this experience can, therefore, help illuminate methods by which to improve operative outcomes in a challenging patient population.
Thompson RW. Systemic Temperature and Paralysis After Thoracoabdominal and Descending Aortic Operations—Invited Critique. Arch Surg. 2003;138(2):180. doi:10.1001/archsurg.138.2.180