Thoracoabdominal aortic aneurysms open repair: a multimodal approach

Thoracoabdominal aortic aneurysms (TAAA) open repair consists of graft replacement with reattachment of the aortic branches. A multimodal approach with different adjuncts has progressively evolved to maximize organ protection and reduce surgical trauma. Preoperative strategies and intraoperative techniques include precise modern imaging, spinal cord (SC) protection, distal aortic and visceral vessels perfusion with left heart bypass and use of new grafts. The surgical technique and the use of the different adjuncts are discussed.