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

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Presentation on theme: "Prevention and detection of spinal cord injury during thoracic and thoracoabdominal aortic repairs  Torazo Wada, MD, Hideki Yao, MD, Takashi Miyamoto,"— Presentation transcript:

1 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 (July 2001) DOI: /S (01)02639-X

2 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  , 80-84DOI: ( /S (01)02639-X)

3 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  , 80-84DOI: ( /S (01)02639-X)

4 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  , 80-84DOI: ( /S (01)02639-X)

5 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  , 80-84DOI: ( /S (01)02639-X)

6 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  , 80-84DOI: ( /S (01)02639-X)

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