Optimal end-organ protection for thoracic and thoracoabdominal aortic aneurysm repair using deep hypothermic circulatory arrest.

Background: Despite the advent of numerous protective strategies, thoracic and thoracoabdominal aortic replacement remains a high risk. While mortality rates have improved over the last 15 years, the incidence of adverse outcomes (including stroke, renal failure, and paraplegia, as well as death) remains at 13% to 30% in all published series. The use of deep hypothermic cardiopulmonary bypass with circulatory arrest has been associated with high morbidity in the past; however, we report a single surgeon's experience of improved end-organ protection with low morbidity and mortality utilizing this technique.