Extracorporeal membrane oxygenation (ECMO) for open thoracoabdominal aortic aneurysm repair (TAAA): How we do it

Open thoracoabdominal aortic aneurysm (TAAA) repair remains associated with significant morbidity and mortality rates despite advancements in surgical techniques. In our technique, we describe partial aortic clamping for debranching of the visceral and renal arteries and the use of extracorporeal membrane oxygenation (ECMO) as an alternative perfusion strategy. The advantage of using our technique is the reduced need for heparinization, a less inflammatory response, no need for cooling of the patient, the reduction of cardiac overload and limited ischemia time to all intra-abdominal organs and lower extremities. ECMO and abdominal debranching with partial thoracic clamping during TAAA repair are ideal for reducing ischemia.