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Renal failure remains a common complication of thoracoabdominal aortic aneurysm repair. The purpose of this randomized clinical trial was to compare two methods of selective renal perfusion—cold crystalloid perfusion versus normothermic blood perfusion— and determine which technique provides the best kidney protection during thoracoabdominal aortic aneurysm repair.

Thirty randomized patients undergoing Crawford extent II thoracoabdominal aortic aneurysm repair with left heart bypass had renal artery perfusion with either 4°C Ringer’s lactate solution (14 patients) or normothermic blood from the bypass circuit (16 patients). Acute renal dysfunction was defined as an elevation in serum creatinine level exceeding 50% of baseline within 10 postoperative days.

One death occurred in each group. One patient in the blood perfusion group experienced renal failure requiring …