Open repair of descending and thoracoabdominal aortic aneurysms under deep hypothermic circulatory arrest.

DHCA is a valuable adjunct in the armamentarium of an aortic surgeon for DTA and TAA repair. Its physiological mechanism for cerebral, spinal cord, and visceral protection has been elucidated in large animal models. Its safety has been demonstrated for both selective and routine use of DTA and TAA repairs with similar early- and late-mortality compared to non-DHCA. It has been associated with improved spinal cord protection and visceral protection compared to non-DHCA, but with prolonged hospital stay in certain series.