1. Direct Spinal Cord Perfusion Pressure Monitoring in Extensive Distal Aortic Aneurysm Repair 
Christian D. Etz, MD, PhD, Gabriele Di Luozzo, MD, Stefano Zoli, MD, Ricardo Lazala, MD, Konstadinos A. Plestis, MD, Carol A. Bodian, DrPH, Randall B. Griepp, MD 
The Annals of Thoracic Surgery 
Volume 87, Issue 6, Pages (June 2009)
DOI: /j.athoracsur
Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

2. Fig 1
(A, B) Segmental artery catheter placement for spinal cord perfusion pressure monitoring.
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )
Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

3. Fig 2
Extent of segmental artery sacrifice and the position of the spinal cord perfusion pressure catheter in each patient. The patients are listed in chronologic order. *Patient number 11 experienced delayed paraparesis.
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )
Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

4. Fig 3
Intraoperative spinal cord perfusion pressure (SCPP; black bars) and mean arterial pressure (MAP; gray bars) recordings before and after segmental artery (SA) sacrifice at 32°C. The proportional spinal cord perfusion pressure as percent of MAP is shown as a trend (dashed line). After segmental artery sacrifice, the spinal cord perfusion pressure drops significantly (p < 0.001*). (CPB = cardiopulmonary bypass.)
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )
Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

5. Fig 4
Course of the spinal cord perfusion pressure (SCPP) with different perfusion strategies. (A) With deep hypothermic circulatory arrest (DHCA; n = 7). Note the significant spinal cord perfusion pressure drop with initiation of cardiopulmonary bypass (CPB) and the gradual recovery during rewarming. (B) With distal aortic perfusion (n = 6). Note the significant drop with proximal aortic cross-clamping (X-clamp), and the moderate restoration of spinal cord perfusion pressure during distal perfusion (DP). (BP = bypass; LBCA = lower body circulatory arrest; MAP = mean arterial pressure; SA = segmental artery.)
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )
Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

6. Fig 5
Postoperative corrected spinal cord perfusion pressure (SCPP: SCPP minus cerebrospinal fluid pressure). In the patient who experienced delayed-onset paraparesis, the corrected spinal cord perfusion pressure was significantly lower during the first 24 hours postoperatively than in the patients who recovered without neurologic deficit (n = 4; p = 0.016).
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )
Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

7. Fig 6
Postoperative central venous pressure (CVP; A), cerebrospinal fluid (CSF) pressure (B), and mean arterial pressure (MAP; C) in the recovered patients (n = 4) versus the paraparetic patient (n = 1). The patient who experienced paraparesis had a significantly higher central venous pressure, but there were no significant differences in cerebrospinal fluid pressure or mean arterial pressure during the first 24 hours postoperatively.
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )
Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions