Spinal Cord Protection During Surgical Procedures on the Descending Thoracic and Thoracoabdominal Aorta

CHEST Journal ◽  
1996 ◽  
Vol 109 (3) ◽  
pp. 799-809 ◽  
Author(s):  
Farid Gharagozloo ◽  
Joel Larson ◽  
Mary J. Dausmann ◽  
Richard F. Neville ◽  
Mario N. Gomes
Keyword(s):  
Spinal Cord ◽  
Surgical Procedures ◽  
Thoracoabdominal Aorta ◽  
Spinal Cord Protection

Spinal cord protection: Development of a paraplegia-preventive solution

1994 ◽  
Vol 58 (1) ◽  
pp. 116-120 ◽  
Author(s):  
Tetsuya Ueno ◽  
Koujirou Furukawa ◽  
Yuuji Katayama ◽  
Hisao Suda ◽  
Tsuyoshi Itoh
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Protection

Results of using cardiopulmonary bypass for spinal cord protection during surgical repair of complex aortic coarctation

2013 ◽  
Vol 24 (1) ◽  
pp. 113-119 ◽  
Author(s):  
Stany Sandrio ◽  
Matthias Karck ◽  
Matthias Gorenflo ◽  
Tsvetomir Loukanov
Keyword(s):  
Spinal Cord ◽  
Cardiopulmonary Bypass ◽  
Aortic Arch ◽  
Aortic Coarctation ◽  
Mild Hypothermia ◽  
Circulatory Arrest ◽  
Main Pulmonary Artery ◽  
Neurologic Complication ◽  
Spinal Cord Protection ◽  
Age Range

AbstractBackgroundThe aim of this study was to evaluate the surgical treatment of complex aortic coarctation using partial cardiopulmonary bypass to increase the spinal cord protection.MethodsA total of 15 patients (age range from 7 to 48 years) underwent coarctation repair through a left posterolateral thoracotomy with cardiopulmonary bypass. Cannulation was performed via the descending aorta and the main pulmonary artery. In all, six surgeries were performed under hypothermic circulatory arrest and nine repairs were performed under mild hypothermia. The clinical outcome regarding the development of restenosis, as well as major neurologic complication, was studied.ResultsThere was no mortality. None of the patients developed paraplegia. Of the 15 patients, two developed a recurrent stenosis at the proximal anastomosis between the aortic arch and the aortic prothesis at a mean follow-up of 5.5 years. In the remaining 13 patients, echocardiography and magnetic resonance imaging showed no evidence of a significant gradient.ConclusionComplex aortic coarctation without hypoplasia of the proximal aortic arch and intra-cardiac anomalies can be repaired with low mortality and neurologic morbidity via a left thoracotomy using cardiopulmonary bypass. The use of cardiopulmonary bypass goes along with a low risk of spinal cord and lower body ischaemia and provides a sufficient amount of time for the anastomoses.

scholarly journals Subarachnoid Fluid Lactate and Paraplegia after Descending Aorta Aneurysmectomy: Two Compared Case Reports

2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
Enrico Giustiniano ◽  
Silvia Eleonora Malossini ◽  
Francesco Pellegrino ◽  
Franco Cancellieri
Keyword(s):  
Cerebrospinal Fluid ◽  
Surgical Procedures ◽  
Case Reports ◽  
Lactate Concentration ◽  
Postoperative Outcome ◽  
The Other ◽  
Thoracoabdominal Aorta ◽  
Descending Aorta ◽  
Helpful Tool ◽  
Cord Injury

We report a comparison of two cases regarding subjects who underwent thoracoabdominal aorta aneurysmectomy. During the procedure we monitored cerebrospinal fluid lactate concentration. One patient experienced postoperative paraplegia and his cerebrospinal fluid lactate concentration was much higher than that in the other case, whose postoperative outcome was uneventful. Consequently we consider that monitoring the lactate concentration in cerebrospinal fluid during thoracic aorta surgical procedures may be a helpful tool to predict the ischemic spine-cord injury allowing for trying to recover it precociously.

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