Introduction
Thoracoabdominal aortic aneurysm (TAAA) repair remains a great
challenge. Some serious complications such as paraplegia,
gastrointestinal complications and acute kidney injury are still
unavoidable1,2. Since the first surgical procedure of
TAAA was first reported by Debakey in 19653, several
approaches have been applied to improve clinical outcome including the
clamp-and-sew technique and the use of distal aortic perfusion. The
maneuver of distal perfusion includes passive bypass without
extracorporeal circulation and extracorporeal circulatory assistance
including left heart bypass (LHB), partial cardiopulmonary bypass and
hypothermic circulation arrest. Cerebrospinal fluid drainage (CSFD),
renal perfusion and selective visceral perfusion (SVP) were also applied
in TAAA repair to prevent visceral, renal and spinal cord
ischemia1. In this report, we applied sequential
aortic cross clamp-and-sew under normothermia to perform the TAAA
repair, with the use of CSFD, renal perfusion and SVP. And the case in
our report was also the TAAA with the largest diameter that had ever
received successful surgical intervention to date. The study was
approved by the institutional review board of Fuwai Hospital. A waiver
of informed consent was granted due to the design of the study.