Direct Monitoring of Reconstructed Segmental Arterial Pressure during Deep Hypothermic Thoracoabdominal Aortic Aneurysm Surgery

Deep hypothermia in thoracoabdominal aortic aneurysm operations is considered extremely useful for ensuring sufficient time to reconstruct the segmental arteries feeding the spinal cord. However, because the amplitude of motor evoked potentials (MEPs) decrease or disappear during deep hypothermia, feasible methods for assessing spinal cord circulation have not yet been reported. Performing additional segmental arterial reconstructions that rely on MEPs is also impractical. In the present case, to ascertain spinal cord circulation under deep hypothermia, we intraoperatively measured the reconstructed segmental arterial pressure in real time and investigated whether sufficient spinal cord blood flow had been attained.