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

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Presentation on theme: "Paul E. Achouh, MD, Anthony L. Estrera, MD, Charles C"— Presentation transcript:

1 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 (September 2007) DOI: /j.athoracsur Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

2 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  , DOI: ( /j.athoracsur ) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

3 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  , DOI: ( /j.athoracsur ) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

4 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  , DOI: ( /j.athoracsur ) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

5 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  , DOI: ( /j.athoracsur ) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

6 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 − )/(exp((−0.7684) + (GFR − )) + 1, with p < 0.05. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

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