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

Slides:

Advertisements

Similar presentations

Aortic Valve Replacement With Patch Enlargement of the Aortic Annulus

Advertisements

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

Results of Coronary Artery Endarterectomy and Coronary Artery Bypass Grafting for Diffuse Coronary Artery Disease Srikrishna Sirivella, MD, Isaac Gielchinsky,

Thoracoabdominal Aneurysm Repair: A 20-Year Perspective

Survival Benefit of Aortic Valve Replacement in Patients With Severe Aortic Stenosis With Low Ejection Fraction And Low Gradient With Normal Ejection.

Darrell Wu, MD, Matt D. Price, MS, Hiruni S. Amarasekara, MS, Susan Y

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

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

Treating Constrictive Pericarditis in a Chinese Single-Center Study: A Five-Year Experience Yiyun Lin, MD, Mi Zhou, MMS, Jian Xiao, MD, Bin Wang, MD,

Improved clinical outcomes in patients undergoing coronary artery bypass grafting with coronary endarterectomy Oz M Shapira, MD, Gabriel Akopian, Ali.

Direct Spinal Cord Perfusion Pressure Monitoring in Extensive Distal Aortic Aneurysm Repair Christian D. Etz, MD, PhD, Gabriele Di Luozzo, MD, Stefano.

Leena Khaitan, MD, Francis P Sutter, Scott M Goldman, MD

Risk factors, outcomes, and clinical manifestations of spinal cord ischemia following thoracic endovascular aortic repair Brant W. Ullery, MD, Albert.

Strategies to Manage Paraplegia Risk After Endovascular Stent Repair of Descending Thoracic Aortic Aneurysms Albert T. Cheung, MD, Alberto Pochettino,

Lisa M. Brown, MD, MAS, David T. Cooke, MD, Elizabeth A. David, MD

Spinal cord complications after thoracic aortic surgery: Long-term survival and functional status varies with deficit severity Mark F. Conrad, MD, Jason.

Influence of Perioperative Hemodynamics on Spinal Cord Ischemia in Thoracoabdominal Aortic Repair Yujiro Kawanishi, MD, Kenji Okada, MD, Masamichi Matsumori,

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

Effect of extended cross-clamp time during thoracoabdominal aortic aneurysm repair Hazim J Safi, MD, Anders Winnerkvist, MD, Charles C Miller, PhD, Dimitrios.

Surgery for acute type A aortic dissection: the Hopital Foch experience (1977–1998) Jean Bachet, MD, Bertrand Goudot, MD, Gilles D Dreyfus, MD, Denis.

Perioperative risk factors for mortality in patients with acute type a aortic dissection Anil Z Apaydin, MD, Suat Buket, MD, Hakan Posacioglu, MD, Fatih.

Lung transplantation for primary and secondary pulmonary hypertension

Perfusion-assisted direct coronary artery bypass: selective graft perfusion in off-pump cases Robert A Guyton, MD, Vinod H Thourani, MD, John D Puskas,

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

Extensive deployment of the stented elephant trunk is associated with an increased risk of spinal cord injury Jorge Flores, MD, PhD, Takashi Kunihara,

Strategies to prevent neurologic deficit based on motor-evoked potentials in type I and II thoracoabdominal aortic aneurysm repair Michael J.H.M. Jacobs,

Aortic Valve Replacement Improves Survival in Severe Aortic Stenosis Associated With Severe Pulmonary Hypertension Ramdas G. Pai, MD, Padmini Varadarajan,

Joseph S. Coselli, MD, Hiruni S. Amarasekara, MS, Susan Y

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

Darrell Wu, MD, Matt D. Price, MS, Hiruni S. Amarasekara, MS, Susan Y

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

Protecting the brain and spinal cord

Risk factors, outcomes, and clinical manifestations of spinal cord ischemia following thoracic endovascular aortic repair Brant W. Ullery, MD, Albert.

Late outcomes of open heart surgery in patients 70 years or older

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

Spinal cord protection during aortic cross-clamping using retrograde venous perfusion Patrick E Parrino, MD, Irving L Kron, MD, Scott D Ross, MD, Kimberly.

Preservation of intercostal arteries during thoracoabdominal aortic aneurysm surgery: A retrospective study Scott D. Ross, MD, Irving L. Kron, MD, Patrick.

Hazim J. Safi, MD, Charles C

National Incidence, Mortality Outcomes, and Predictors of Spinal Cord Ischemia After Thoracic Endovascular Aortic Repair Salvatore T. Scali, Kristina.

Giancarlo Piano, MD, Bruce L. Gewertz, MD Journal of Vascular Surgery

Cardiac Arrhythmia After Open Thoracoabdominal Aortic Aneurysm Repair

Predicting the Risk of Paraplegia After Thoracic and Thoracoabdominal Aneurysm Repair Stefano Zoli, MD, Fabian Roder, MS, Christian D. Etz, MD, PhD,

Paraplegia After Thoracoabdominal Aortic Aneurysm Repair: Is Dissection a Risk Factor? Joseph S. Coselli, Scott A. LeMaire, Luiz Poli de Figueiredo,

State-of-the-art of neuromonitoring for prevention of immediate and delayed paraplegia in thoracic and thoracoabdominal aorta surgery Jean-Michel Guérit,

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,

A. Thomas Pezzella, MD, Sari D

Total arch replacement using aortic arch branched grafts with the aid of antegrade selective cerebral perfusion Teruhisa Kazui, MD, Naoki Washiyama,

Repair of Thoracoabdominal Aortic Aneurysms in Octogenarians

Results of Thoracic Endovascular Aortic Repair 6 Years After United States Food and Drug Administration Approval Asad A. Shah, MD, Michael E. Barfield,

James D Luketich, Michael E Burt The Annals of Thoracic Surgery

Left Ventricular Reconstruction Benefits Patients With Dilated Ischemic Cardiomyopathy Atsushi Yamaguchi, MD, Hideo Adachi, MD, Koji Kawahito, MD, Seiichiro.

Thoracoabdominal Aneurysm Repair: A 20-Year Perspective

Repair of Truncus Arteriosus and Aortic Arch Interruption: Outcome Analysis Takashi Miyamoto, MD, Nicodème Sinzobahamvya, MD, Daiva Kumpikaite, MD, Boulos.

Neal S Goldstein, MD The Annals of Thoracic Surgery

Stefano Zoli, MD, Christian D

Strategies to prevent neurologic deficit based on motor-evoked potentials in type I and II thoracoabdominal aortic aneurysm repair Michael J.H.M. Jacobs,

Yangfeng Tang, MD, Zilin Liao, MD, Lin Han, MD, Zhiyun Xu, MD

Joseph S Coselli, MD, Lori D Conklin, MD, Scott A LeMaire, MD

Adnan Cobanoglu, MD, Jess M Schultz, MD The Annals of Thoracic Surgery

Dumbor L. Ngaage, MD, FRCS (C-Th), Michael E. Cowen, FRCS

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

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

Coronary malperfusion due to type a aortic dissection: mechanism and surgical management Koji Kawahito, MD, Hideo Adachi, MD, Sei-ichiro Murata, MD,

Left Ventricular End-Diastolic Pressure Predicts Survival in Coronary Artery Bypass Graft Surgery Patients Jeevan Nagendran, MD, PhD, Colleen M. Norris,

Neuromonitor-guided repair of thoracoabdominal aortic aneurysms

Surgical Outcomes of Acute Type A Aortic Dissection in Elderly Patients Kazunori Komatsu, MD, Tamaki Takano, MD, PhD, Takamitsu Terasaki, MD, Yuko Wada,

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

Presentation transcript:

Prevention and detection of spinal cord injury during thoracic and thoracoabdominal aortic repairs Torazo Wada, MD, Hideki Yao, MD, Takashi Miyamoto, MD, Sukemasa Mukai, MD, Mitsuhiro Yamamura, MD The Annals of Thoracic Surgery Volume 72, Issue 1, Pages 80-84 (July 2001) DOI: 10.1016/S0003-4975(01)02639-X

Fig 1 Perioperative monitoring, showing how to record somatosensory evoked potentials (SEP) and evaluate SCPP. (CSFP = cerebrospinal fluid pressure; EEG = electro-encephalogram; MDAP = mean distal aortic pressure; SCPP = spinal cord perfusion pressure.) The Annals of Thoracic Surgery 2001 72, 80-84DOI: (10.1016/S0003-4975(01)02639-X)

Fig 2 Actuarial survival curve (Kaplan-Meier method) showing that 90% of the hospital survivors were alive at 1 year after operation, 78.7% at 5 years, and 56.8% at 10 years. The Annals of Thoracic Surgery 2001 72, 80-84DOI: (10.1016/S0003-4975(01)02639-X)

Fig 3 Relation between somatosensory evoked potential (SEP) monitoring and incidence of paraplegia (n = 82). (F-F = femoral vein to femoral artery; SCPP = spinal cord perfusion pressure.) The Annals of Thoracic Surgery 2001 72, 80-84DOI: (10.1016/S0003-4975(01)02639-X)

Fig 4 Mean cerebrospinal fluid pressure (CSFP) during aortic cross-clamping in 60 patients with no significant ischemic somatosensory evoked potential (SEP) changes and 22 with significant ischemic SEP changes. Cerebrospinal fluid pressure rose to more than 20 mm Hg in 2 patients, who experienced paraplegia. The Annals of Thoracic Surgery 2001 72, 80-84DOI: (10.1016/S0003-4975(01)02639-X)

Fig 5 Spinal cord perfusion pressure (SCPP) during aortic cross-clamping in 60 patients with no significant ischemic somatosensory evoked potential (SEP) changes and 22 with significant ischemic SEP changes. Spinal cord perfusion pressure was less than 40 mm Hg in 5 patients. Two of 3 patients with significant ischemic SEP changes during aortic cross-clamping experienced paraplegia. The Annals of Thoracic Surgery 2001 72, 80-84DOI: (10.1016/S0003-4975(01)02639-X)