Paul E. Achouh, MD, Anthony L. Estrera, MD, Charles C

Slides:

Advertisements

Similar presentations

Morphologic Spectrum of Ventriculoarterial Connection in Hearts With Double Inlet Left Ventricle: Implications for Surgical Procedures Hideki Uemura, MD,

Advertisements

Paul E. Achouh, MD, Anthony L. Estrera, MD, Charles C

Analysis of motor and somatosensory evoked potentials during thoracic and thoracoabdominal aortic aneurysm repair Kourosh Keyhani, DO, Charles C. Miller,

Risk Index for Postoperative Acute Kidney Injury After Valvular Surgery Using Cardiopulmonary Bypass Takashi Yamauchi, MD, PhD, Shigeru Miyagawa, MD,

Rana O. Afifi, MD, Harleen K. Sandhu, MD, MPH, Amy. E

Outcomes of Reintervention on the Autograft After Ross Procedure

Thoracic and Thoracoabdominal Aneurysm Repair: Is Reimplantation of Spinal Cord Arteries a Waste of Time? Christian D. Etz, MD, James C. Halstead, MA.

Postoperative risk factors for delayed neurologic deficit after thoracic and thoracoabdominal aortic aneurysm repair: A case-control study Ali Azizzadeh,

Anthony L. Estrera, MD, Zsolt Garami, MD, Charles C

Autologous Platelet-Rich Plasma Reduces Transfusions During Ascending Aortic Arch Repair: A Prospective, Randomized, Controlled Trial Shao Feng Zhou,

Risk of Spinal Cord Injury After Operations of Recurrent Aneurysms of the Descending Aorta Jorge Flores, MD, Norihiko Shiiya, MD, PhD, Takashi Kunihara,

Extent of Aortic Coverage and Incidence of Spinal Cord Ischemia After Thoracic Endovascular Aneurysm Repair Robert J. Feezor, MD, Tomas D. Martin, MD,

Mina L. Boutrous, MD, Rana O. Afifi, MD, Hazim J. Safi, MD, Anthony L

Ali Azizzadeh, MD, Kourosh Keyhani, DO, Charles C

Shangyi Ji, MD, Jianan Yang, MD, Xiaoqing Ye, MD, Xiaolei Wang, MD

Glomerular filtration rate is superior to serum creatinine for prediction of mortality after thoracoabdominal aortic surgery Tam T.T. Huynh, MD, Randolph.

Thoracoabdominal Aortic Aneurysm Repair in a Patient With a Left Ventricular Assist Device Kazuma Date, MD, Tatsuo Kaneko, MD, PhD, Masahiko Edure, MD,

Anthony L. Estrera, MD, Charles C

Analysis of motor and somatosensory evoked potentials during thoracic and thoracoabdominal aortic aneurysm repair Kourosh Keyhani, DO, Charles C. Miller,

Postoperative renal function preservation with nonischemic femoral arterial cannulation for thoracoabdominal aortic repair Charles C. Miller, PhD, Joshua.

Development of New Acute Dissection in the Ascending Aorta After Type B Dissection: Intramural Hematoma Is Not Benign Samuel S. Leake, BS, Harleen K.

Simple Index to Predict Likelihood of Skilled Nursing Facility Admission After Coronary Artery Bypass Grafting Among Older Patients David C. Chang, PhD,

Risk Modeling to Optimize Patient Selection for Management of the Descending Thoracic Aortic Aneurysm Akiko Tanaka, MD, PhD, Harleen K. Sandhu, MD, MPH,

The hybrid elephant trunk procedure: A single-stage repair of an ascending, arch, and descending thoracic aortic aneurysm Ali Azizzadeh, MD, Anthony.

Surgical Resection of a Giant Coronary Aneurysm

Descending thoracic aortic aneurysm: surgical approach and treatment using the adjuncts cerebrospinal fluid drainage and distal aortic perfusion Anthony.

Surgical Repair of a Chronic Traumatic Sternal Fracture

Anthony L. Estrera, MD, Roy Sheinbaum, MD, Charles C

James D. St. Louis, MD The Annals of Thoracic Surgery

Who Do You Say You Are? The Annals of Thoracic Surgery

Use of Amiodarone After Major Lung Resection

Modified Ross Procedure to Prevent Autograft Dilatation

Management of common carotid artery dissection due to extension from acute type A (DeBakey I) aortic dissection Kristofer M. Charlton-Ouw, MD, FACS,

Hazim J. Safi, MD, Charles C

Anomalous Origin of Left Pulmonary Artery From Left Subclavian Artery

Prevention and detection of spinal cord injury during thoracic and thoracoabdominal aortic repairs Torazo Wada, MD, Hideki Yao, MD, Takashi Miyamoto,

Ali Azizzadeh, MD, Kristofer M

Glomerular filtration rate is a predictor of mortality after endovascular abdominal aortic aneurysm repair Ali Azizzadeh, MD, Luis A. Sanchez, MD, Charles.

Redo Aortic Valve Replacement in Children

Intentional left subclavian artery coverage during thoracic endovascular aortic repair for traumatic aortic injury Cameron L. McBride, BS, Joseph J.

Editorial Board, January 2010

Severe Two-Vessel Ostial Stenosis of the Main Coronary Arteries in a Patient With Transposition of the Great Arteries After an Arterial Switch Operation

Daniel R. Wong, MD, MPH, Joseph S

Spinal Cord Perfusion and Protection During Descending Thoracic and Thoracoabdominal Aortic Surgery: The Collateral Network Concept Randall B. Griepp,

Simultaneous Repair of Multiple Aortic Aneurysms: Be Courageous in Minimally Invasive Era Yoshiaki Saito, MD, Ikuo Fukuda, MD, PhD, Kozo Fukui, MD, PhD,

Deterioration of a Tricuspid Bioprosthesis Due to Adhesion of the Native Valve Herbert Gutermann, MD, Willem Flameng, MD, PhD, Paul Herijgers, MD, PhD

Patrick O. Myers, MD The Annals of Thoracic Surgery

Gastrointestinal complications after descending thoracic and thoracoabdominal aortic repairs: A 14-year experience Paul E. Achouh, MD, Ken Madsen, MD,

Paul Urbanski, MD, PhD The Annals of Thoracic Surgery

Operative Intercostal Nerve Blocks With Long-Acting Bupivacaine Liposome for Pain Control After Thoracotomy Kamal G. Khalil, MD, FACS, Mina L. Boutrous,

Cost-Effectiveness of Mitral Valve Repair Versus Replacement by Biologic or Mechanical Prosthesis Ariel Beresniak, MD, PhD, Brigitte Sabatier, PharmD,

Pallav J. Shah, MD, Anthony L. Estrera, MD, Charles C

Ali Khoynezhad, MD, PhD, Matthew J. Kruse, BS, Carlos E

Invited Commentary The Annals of Thoracic Surgery

Optimization of Aortic Arch Replacement: Two-Stage Approach

Hazim J Safi, MD, Charles C Miller, PhD The Annals of Thoracic Surgery

Anthony L. Estrera, MD, David C

Bilateral Cervical Lung Hernia With T1 Nerve Compression

Combined Endovascular and Surgical Procedure for Recurrent Thoracoabdominal Aortic Aneurysm Masato Yoshida, MD, Nobuhiko Mukohara, MD, Tsutomu Shida,

Experience With Bovine Pericardium for the Reconstruction of the Aortic Arch in Patients Undergoing a Norwood Procedure Victor O. Morell, MD, Peter A.

Descending Thoracic Aortic Aneurysm Repair: 12-Year Experience Using Distal Aortic Perfusion and Cerebrospinal Fluid Drainage Anthony L. Estrera, MD,

Michael H. Hines, MD, Neal D. Kon, MD The Annals of Thoracic Surgery

Heather M. Phelps, DO, William T

Hazim J. Safi, MD, Anthony L. Estrera, MD, Charles C

The Impact of New Technology on Cardiothoracic Surgical Practice

Selecting patients with mitral regurgitation and left ventricular dysfunction for isolated mitral valve surgery Constance K. Haan, MD, Cristina I. Cabral,

Staged repair of extensive aortic aneurysms

Neuromonitor-guided repair of thoracoabdominal aortic aneurysms

Surgical Reconstruction of Peripheral Pulmonary Arteries: Strategies, Outcomes, and New Classification Abdulaziz Al-Khaldi, MD, MS, Omar Tamimi, MD

Harvey Edward Garrett, MD, Bradley A. Wolf, MD

Presentation transcript:

Role of Somatosensory Evoked Potentials in Predicting Outcome During Thoracoabdominal Aortic Repair Paul E. Achouh, MD, Anthony L. Estrera, MD, Charles C. Miller, PhD, Ali Azizzadeh, MD, Adel Irani, MD, Tara L. Wegryn, MD, Hazim J. Safi, MD The Annals of Thoracic Surgery Volume 84, Issue 3, Pages 782-788 (September 2007) DOI: 10.1016/j.athoracsur.2007.03.066 Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Patient in the surgical position, with the different electroencephalogram (EEG) and somatosensory evoked potential leads in place. (A = somatosensory evoked potential stimulatory leads to posterior tibialis nerve at the level of malleolus; B = somatosensory evoked potential recording leads at the level of the popliteal fossa; C = somatosensory evoked potential recording leads at the level of the cervical spine (C5); D = somatosensory evoked potential recording leads at the level of the vertex; E = electroencephalogram leads.) The Annals of Thoracic Surgery 2007 84, 782-788DOI: (10.1016/j.athoracsur.2007.03.066) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Normal somatosensory evoked potential tracing. (A) Baseline somatosensory evoked potential tracing, obtained just before the beginning of the surgical procedure, showing normal bilateral signals at all three levels (popliteal, cervical, and cortical) after peroneal stimulation. (B) Normal somatosensory evoked potential tracing obtained during the surgical procedure. The actual somatosensory evoked potential tracing (represented by full line) is comparable to the baseline somatosensory evoked potential (represented by dotted line). The Annals of Thoracic Surgery 2007 84, 782-788DOI: (10.1016/j.athoracsur.2007.03.066) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Left leg cannulation. Somatosensory evoked potential tracing shows a loss of all signals in the left leg secondary to cannulation of the left femoral artery. On the right side, the right popliteal signal is present (A); there are also normal signals in the cervical and cortical channels (B and C, respectively). The Annals of Thoracic Surgery 2007 84, 782-788DOI: (10.1016/j.athoracsur.2007.03.066) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Spinal change. All signals on the left side were already lost after femoral artery cannulation. On the right side, the right popliteal signal is normal (A), whereas both cervical and cortical signals are lost (B and C, respectively). The Annals of Thoracic Surgery 2007 84, 782-788DOI: (10.1016/j.athoracsur.2007.03.066) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Graph showing the correlation between low preoperative glomerular filtration rate (GFR) as assessed by Cockroft-Gault formula and spinal cord dysfunction on somatosensory evoked potential (SSEP) monitoring. The correlation equation was exp((−0.7684) + (GFR − 0.00970)/(exp((−0.7684) + (GFR − 0.00970)) + 1, with p < 0.05. The Annals of Thoracic Surgery 2007 84, 782-788DOI: (10.1016/j.athoracsur.2007.03.066) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions