Society For Clinical Vascular Surgery

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"Distal First" Approach for Open Thoracoabdominal Aneurysm Repair
Julia Glaser MD, Mary Siki BS, Nimesh Desai MD, Ben Jackson MD, Scott Damrauer MD, Grace Wang MD, Ronald Fairman MD, Paul Foley MD
Hospital of the University of Pennsylvania, Philadelphia PA

Paraplegia due to spinal cord ischemia is a feared consequence of open thoracoabdominal aneurysm (TAAA) repair. At our institution, we often use partial left heart bypass during our open TAAA repairs. When possible, we perform the distal anastomoses first, minimizing the time on bypass and maximizing the operative time with pulsatile flow to the pelvis. Here we present a case of a 60-year-old female with a history of Marfan’s Syndrome where this technique was used for an extent III TAAA repair.

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