To discuss the application of deep hypothermic circulatory arrest in surgical treatment of complex thoracoabdominal aortic aneurysms and its near-midterm effect.

The clinical data of 34 cases of thoracoabdominal aortic aneurysm in the center from August 2009 to June 2018 were analyzed retrospectively. All the patients underwent surgery under deep hypothermic circulatory arrest.There were 23 males and 11 females; aged 23-67 years, mean(42.26±10.96) years old; Crawford type Ⅰ in 12 cases and Crawford type Ⅱ in 22 cases; aneurysms with a maximum diameter of 50-120 mm, mean(65.26±16.09) mm; Marfan syndrome 15 cases, atherosclerosis 14 cases, aortic coarctation in 5 cases; 22 cases of hypertension; 28 cases of first aortic surgery, 6 cases of re-aortic surgery.Surgical transthoracic and abdominal incision, extracapsular approach, femoral artery and inferior vena cava intubation, deep hypothermic circulatory arrest technique to complete proximal anastomosis, arterial tube reconstruction of intercostal artery, abdominal organ blood supply artery and four The bifurcated vessels were anastomosed, and the bifurcated vessels were anastomosed with the " Y" type artificial blood vessel trunk. The bilateral radial arteries were end-to-end anastomosis in the 10 mm artificial blood vessels of the " Y" type artificial blood vessels.

There were no complications of cranial nerve system in the whole group, deep hypothermic circulatory arrest(17.68±4.88) min, ventilator assist time(34.88±16.04) hours, postoperative renal failure in 5 cases, after CRRT treatment After recovery, 1 case of paraplegia after operation, muscle strength recovered after cerebrospinal fluid drainage and decompression, and 1 case died in the whole group, and died of multiple organ failure. The patients were followed up for 3 months to 5 years, and the results were satisfactory. The survivors did not die. The survivors did not die.However, 5 patients underwent thoracic aortic replacement under deep hypothermic circulatory arrest for the first time, and 4 patients underwent reoperation because of distal vasodilation. The reconstructed intercostal artery occlusion occurred in 4 patients, but no paraplegia occurred.

When cross clamping the aorta is not feasible, it is safe to perform proximal anastomosis with deep hypothermic circulatory arrest.

Deep hypothermic circulatory arrest; Thoracoabdominal aortic aneurysm; Surgical treatment