Spinal cord protection during thoracoabdominal aortic aneurysm surgery
نویسنده
چکیده
Introduction Postoperative paraplegia including paraparesis is a devastating complication after descending thoracic aortic aneurysm (DTAA) and thoracoabdominal aortic aneurysm (TAAA) repair surgery. This lecture will be focused on the pathophysiological mechanisms for the development of postoperative paraplegia, the strategies to prevent the development of postoperative paraplegia, and anesthetic managements during the monitoring of motor evoked potentials (MEPs).
منابع مشابه
Spinal Cord Protection for Descending or Thoracoabdominal Aortic Aneurysm Repair
The mortality and morbidity of extensive thoracoabdominal aorta replacement has improved markedly in recent years [1]. However, postoperative paraplegia from spinal cord infarction remains the most devastating complication that faces patients undergoing surgery on the thoracoabdominal aorta because loss of lowerlimb function imposes severe constraints on the quality of life. Additionally, parap...
متن کاملStaged approach for spinal cord protection in hybrid thoracoabdominal aortic aneurysm repair.
At present, there are three available options for surgical thoracoabdominal aortic aneurysm (TAAA) repair: conventional open surgery, total endovascular repair, and a hybrid approach, involving conventional surgical and endovascular techniques. Each modality has a different risk/benefit profile, requiring careful patient selection. Spinal cord injury (SCI) due to compromised blood supply follow...
متن کاملThe use of neuromonitoring in descending and thoraco-abdominal aortic aneurysm surgery: a review
Without surgical repair thoracic aortic aneurysms are a lethal disease with poor prognosis. An extensive major operation is required to correct an aneurysm that involves the descending or thoracoabdominal aorta. Particular considerations must be made to protection of all abdominal organs, the brain and the spinal cord which are all at risk. Consequently there is a risk that these patients post ...
متن کاملReview Articles Spinal Cord Protection During Thoracoabdominal Aneurysm Repair
one reported series, the 5-year survival rate for patients with spinal cord injury was 44%, whereas it was 62% for those without spinal cord injury.19 Postoperative spinal cord injury is caused by several factors including ischemia, reperfusion injury, and postoperative hemodynamics. Many methods of protecting the spinal cord during thoracoabdominal aneurysm repair have been devised. These incl...
متن کاملTear of joy or sorrow: endovascular stent grafting for thoracoabdominal aorta.
Surgery for thoracoabdominal aorta actually began before the era of cardiopulmonary bypass. In the mid-1950s, Ellis et al., Etheredge et al., and DeBakey et al. opened a field of surgery for throacoabdominal aorta using allograft. In 1965, DeBakey reported their results as 26% mortality in 42 patients with thoracoabdominal aortic aneurysms who underwent the extra-anatomical reconstruction of th...
متن کامل