Intraoperative immunomodulation during left heart bypass in open thoracoabdominal aortic aneurysm repair

Federico Pascucci; Tommaso Donati; Giovanni Tinelli; Gabriella Arlotta; Antonio Luparelli; Yamume Tshomba

doi:10.1016/j.jvscit.2023.101276

Intraoperative immunomodulation during left heart bypass in open thoracoabdominal aortic aneurysm repair

J Vasc Surg Cases Innov Tech. 2023 Aug 1;9(3):101276. doi: 10.1016/j.jvscit.2023.101276. eCollection 2023 Sep.

Authors

Federico Pascucci¹, Tommaso Donati¹, Giovanni Tinelli¹, Gabriella Arlotta², Antonio Luparelli¹, Yamume Tshomba¹

Affiliations

¹ Vascular Surgery Unit, Fondazione Policlinico Universitario A Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
² Cardiac Anesthesia and Intensive Care Unit, Fondazione Policlinico Universitario A Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.

Abstract

Despite the technical innovations introduced in the previous decades, open thoracoabdominal aortic aneurysm repair still represents an enormous challenge for patients and surgeons. Logically, the systemic inflammatory response resulting from these massive operations appears considerable; however, the response has never been thoroughly investigated. In addition, intraoperative adjuncts to modulate the postoperative activation of the immune system have not yet been introduced into clinical practice. We report a case of intraoperative hemadsorption during open repair of a thoracoabdominal aortic aneurysm through the introduction of a CytoSorb device (CytoSorbents Corp) in the left heart bypass circuit. The technique appeared feasible and safe and probably contributed to the good clinical outcomes.

Keywords: CytoSorb; Left heart bypass; Thoracoabdominal aortic aneurysm.

Publication types

Case Reports