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Much of today's success in the surgical treatment of aortic disease is the direct result of innovation aimed at the continuous improvement of surgical technique, lowering mortality and morbidity rates, even in high-risk patients and procedures. The most recent thoracoabdominal surgery series clearly illustrates this success. From 1989 to 1994 at Cedars-Sinai, the left heart bypass technique was used for thoracoabdominal aneurysm surgery. Beginning in 1994, total circulatory arrest was introduced, producing significantly better results.
Cedars-Sinai today has one of the lowest reported incidences of paraplegia and renal failure for patients undergoing thoracoabdominal aortic surgery. These outcomes were achieved in a very high-risk group of older patients (with hypertension, heart problems and a history of smoking) undergoing complex surgery requiring an extensive surgical site. Given the highly specialized, complex nature of this surgery in a high-risk patient population, this represents a remarkable achievement.