Paraplegia after extensive thoracic and thoracoabdominal aortic aneurysm repair: Does critical spinal cord ischemia occur postoperatively? Christian.

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Presentation transcript:

Paraplegia after extensive thoracic and thoracoabdominal aortic aneurysm repair: Does critical spinal cord ischemia occur postoperatively? Christian D. Etz, MD, Maximilian Luehr, MS, Fabian A. Kari, MS, Carol A. Bodian, DrPH, Douglas Smego, MD, Konstadinos A. Plestis, MD, Randall B. Griepp, MD The Journal of Thoracic and Cardiovascular Surgery Volume 135, Issue 2, Pages 324-330 (February 2008) DOI: 10.1016/j.jtcvs.2007.11.002 Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Permanent spinal cord injury (n = 20) after thoracic and thoracoabdominal aortic aneurysm (TAA/A) repair with segmental artery sacrifice and somatosensory evoked potential (SSEP) monitoring in 858 patients. Three additional patients had transient spinal cord ischemia (intraoperative = 1; late–delayed = 2), all of whom recovered with vasopressor therapy. The Journal of Thoracic and Cardiovascular Surgery 2008 135, 324-330DOI: (10.1016/j.jtcvs.2007.11.002) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Extent of segmental artery (SA) sacrifice during thoracoabdominal aneurysm repair (TAASA) in paraplegic versus recovered patients precisely defining the proximal and distal extent of aneurysm resection. n.s., Not significant. The Journal of Thoracic and Cardiovascular Surgery 2008 135, 324-330DOI: (10.1016/j.jtcvs.2007.11.002) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Mean central venous pressure (mCVP) during postoperative intensive care unit stay after thoracic and thoracoabdominal aortic aneurysm replacement. The Journal of Thoracic and Cardiovascular Surgery 2008 135, 324-330DOI: (10.1016/j.jtcvs.2007.11.002) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 A, Mean aortic pressure (MAP) during postoperative intensive care unit stay after thoracic and thoracoabdominal aortic aneurysm replacement. B, Postoperative mean aortic pressure relative to antecedent baseline pressure (rMAP) before surgical intervention (A. radialis; no vasoactive drugs added to the patient's medication). The Journal of Thoracic and Cardiovascular Surgery 2008 135, 324-330DOI: (10.1016/j.jtcvs.2007.11.002) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions