| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 2001;72:481-486
© 2001 The Society of Thoracic Surgeons
a Department of Cardiothoracic and Vascular Surgery, The University of Texas at Houston Medical School, Memorial Hermann Hospital, Houston, Texas, USA
Address reprint requests to Dr Safi, Department of Cardiothoracic and Vascular Surgery, UTH Medical Center, 6410 Fannin St, Suite 450, Houston, TX 77030
e-mail: hazim.i.safi{at}uth.tmc.edu
Presented at the Forty-seventh Annual Meeting of the Southern Thoracic Surgical Association, Marco Island, FL, Nov 9–11, 2000.
Background. Neurologic deficit (paraplegia or paraparesis) remains a significant morbidity in the repair of descending thoracic aortic aneurysm.
Methods. Between February 1991 and February 2000, we operated on 182 patients for descending thoracic aortic aneurysm. For the purpose of this study—to identify the impact of the combined adjuncts distal aortic perfusion and cerebrospinal fluid (CSF) drainage on neurologic outcome—we selected the 148 of 182 nonemergent patients who had received conventional treatment (simple cross-clamping with or without adjuncts). The mean patient age was 61 years, and 49 of the 148 (33%) patients were women. Nine of the 148 patients (6%) had acute type B dissections. We compared the results of 105 of the 148 patients (71%) who received the combined adjuncts of CSF drainage and distal aortic perfusion with the remaining 43 (29%) patients who underwent repair using the simple cross-clamp with or without the addition of a single adjunct.
Results. Overall 30-day mortality was 13 of 148 patients (8.8%). Overall early neurologic deficit was 4 of 148 (2.7%): 1 of 105 (0.9%) patients who had received distal aortic perfusion and CSF drainage, versus 3 of 43 (7%) in all other patients (p < 0.04).
Conclusions. In our practice the use of the combined adjuncts of CSF drainage and distal aortic perfusion has all but eliminated the incidence of immediate postoperative neurologic deficit in nonemergent patients with aneurysms of the descending thoracic aorta.
This article has been cited by other articles:
|
|
 |
|
  G. Mariscalco, G. Piffaretti, M. Tozzi, A. Bacuzzi, G. Carrafiello, A. Sala, and P. Castelli Predictive factors for cerebrovascular accidents after thoracic endovascular aortic repair. Ann. Thorac. Surg., December 1, 2009; 88(6): 1877 - 1881. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Minatoya, H. Ogino, H. Matsuda, H. Sasaki, T. Yagihara, and S. Kitamura Replacement of the descending aorta: recent outcomes of open surgery performed with partial cardiopulmonary bypass. J. Thorac. Cardiovasc. Surg., August 1, 2008; 136(2): 431 - 435. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. F. Conrad and R. P. Cambria Contemporary Management of Descending Thoracic and Thoracoabdominal Aortic Aneurysms: Endovascular Versus Open Circulation, February 12, 2008; 117(6): 841 - 852. [Full Text] [PDF]
|
|
|
|
|
|
L. G. Svensson, N. T. Kouchoukos, D. C. Miller, J. E. Bavaria, J. S. Coselli, M. A. Curi, H. Eggebrecht, J. A. Elefteriades, R. Erbel, T. G. Gleason, et al. Expert Consensus Document on the Treatment of Descending Thoracic Aortic Disease Using Endovascular Stent-Grafts Ann. Thorac. Surg., January 1, 2008; 85(1_Supplement): S1 - S41. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. T. Gutsche, A. T. Cheung, M. L. McGarvey, W. G. Moser, W. Szeto, J. P. Carpenter, R. M. Fairman, A. Pochettino, and J. E. Bavaria Risk Factors for Perioperative Stroke After Thoracic Endovascular Aortic Repair Ann. Thorac. Surg., October 1, 2007; 84(4): 1195 - 1200. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. L. Kahn and M. D. Dake Stent Graft Management of Stable, Uncomplicated Type B Aortic Dissection Perspectives in Vascular Surgery and Endovascular Therapy, June 1, 2007; 19(2): 162 - 169. [Abstract] [PDF]
|
|
|
|
|
|
J. E. Bavaria, J. J. Appoo, M. S. Makaroun, J. Verter, Z.-F. Yu, R. S. Mitchell, and Gore TAG Investigators Endovascular stent grafting versus open surgical repair of descending thoracic aortic aneurysms in low-risk patients: A multicenter comparative trial J. Thorac. Cardiovasc. Surg., February 1, 2007; 133(2): 369 - 377. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Weigang, M. Hartert, M. P. Siegenthaler, N. A. Beckmann, R. Sircar, G. Szabo, C. D. Etz, M. Luehr, P. von Samson, and F. Beyersdorf Perioperative Management to Improve Neurologic Outcome in Thoracic or Thoracoabdominal Aortic Stent-Grafting Ann. Thorac. Surg., November 1, 2006; 82(5): 1679 - 1687. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. J. Appoo, W. G. Moser, R. M. Fairman, K. F. Cornelius, A. Pochettino, E. Y. Woo, J. E. Kurichi, J. P. Carpenter, and J. E. Bavaria Thoracic aortic stent grafting: Improving results with newer generation investigational devices J. Thorac. Cardiovasc. Surg., May 1, 2006; 131(5): 1087 - 1094. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. R. Puchakayala and W. C Lau Descending thoracic aortic aneurysms CEACCP, April 1, 2006; 6(2): 54 - 59. [Full Text] [PDF]
|
|
|
|
|
|
H. J. Safi, A. L. Estrera, C. C. Miller, T. T. Huynh, E. E. Porat, A. Azizzadeh, R. Meada, and J. S. Goodrick Evolution of Risk for Neurologic Deficit After Descending and Thoracoabdominal Aortic Repair Ann. Thorac. Surg., December 1, 2005; 80(6): 2173 - 2179. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. T. Cheung, A. Pochettino, M. L. McGarvey, J. J. Appoo, R. M. Fairman, J. P. Carpenter, W. G. Moser, E. Y. Woo, and J. E. Bavaria Strategies to Manage Paraplegia Risk After Endovascular Stent Repair of Descending Thoracic Aortic Aneurysms Ann. Thorac. Surg., October 1, 2005; 80(4): 1280 - 1289. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. L. Estrera, C. C. Miller III, E. P. Chen, R. Meada, R. H. Torres, E. E. Porat, T. T. Huynh, A. Azizzadeh, and H. J. Safi Descending Thoracic Aortic Aneurysm Repair: 12-Year Experience Using Distal Aortic Perfusion and Cerebrospinal Fluid Drainage Ann. Thorac. Surg., October 1, 2005; 80(4): 1290 - 1296. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. G. Rubin Extra-anatomic Visceral Revascularization and Endovascular Stent-Grafting for Complex Thoracoabdominal Aortic Lesions Perspectives in Vascular Surgery and Endovascular Therapy, September 1, 2005; 17(3): 227 - 234. [Abstract] [PDF]
|
|
|
|
|
|
H. T. Hassoun, M. D. Dake, L. G. Svensson, R. K. Greenberg, R. P. Cambria, R. D. Moore, and J. S. Matsumura Multi-institutional Pivotal Trial of the Zenith TX2 Thoracic Aortic Stent-Graft for Treatment of Descending Thoracic Aortic Aneurysms: Clinical Study Design Perspectives in Vascular Surgery and Endovascular Therapy, September 1, 2005; 17(3): 255 - 264. [Abstract] [PDF]
|
|
|
|
 |
|
 M. R. Puchakalaya and K. K. Tremper Brown-Sequard Syndrome Following Removal of a Cerebrospinal Fluid Drainage Catheter After Thoracic Aortic Surgery Anesth. Analg., August 1, 2005; 101(2): 322 - 324. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Kusagawa, T. Shimono, M. Ishida, T. Suzuki, F. Yasuda, U. Yuasa, K. Onoda, I. Yada, T. Hirano, K. Takeda, et al. Changes in False Lumen After Transluminal Stent-Graft Placement in Aortic Dissections: Six Years' Experience Circulation, June 7, 2005; 111(22): 2951 - 2957. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Matsuda, A. Zaima, Y. Hino, and Y. Okita Thoracic aneurysm expansion secondary to collateral supplies via thyrocervical trunk and intercostal arteries in a patient after thromboexclusion Eur. J. Cardiothorac. Surg., April 1, 2004; 25(4): 658 - 660. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. S. Coselli, S. A. LeMaire, L. D. Conklin, and G. J. Adams Left heart bypass during descending thoracic aortic aneurysm repair does not reduce the incidence of paraplegia Ann. Thorac. Surg., April 1, 2004; 77(4): 1298 - 1303. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H J Safi and P R Taylor Open surgery for thoracic aortic disease Heart, August 1, 2003; 89(8): 825 - 826. [Full Text] [PDF]
|
|
|
|
|
|
J. C. Halstead, M. Baghai, E. Lim, J. J. Dunning, and S. R. Large A method for descending thoracic aortic replacement retaining a posterior strip bearing intercostal vessels Ann. Thorac. Surg., May 1, 2003; 75(5): 1660 - 1661. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. J. Oberwalder, K. Tiesenhausen, K. Hausegger, and B. Rigler Successful reversal of delayed paraplegia after endovascular stent grafting J. Thorac. Cardiovasc. Surg., December 1, 2002; 124(6): 1259 - 1260. [Full Text]
|
|
|
|
|
|
T. Shimono, N. Kato, F. Yasuda, T. Suzuki, U. Yuasa, K. Onoda, T. Hirano, K. Takeda, and I. Yada Transluminal Stent-Graft Placements for the Treatments of Acute Onset and Chronic Aortic Dissections Circulation, September 24, 2002; 106(12_suppl_1): I-241 - I-247. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. T. Cheung, S. J. Weiss, M. L. McGarvey, M. M. Stecker, M. S. Hogan, A. Escherich, and J. E. Bavaria Interventions for reversing delayed-onset postoperative paraplegia after thoracic aortic reconstruction Ann. Thorac. Surg., August 1, 2002; 74(2): 413 - 421. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. M. Hochheiser, D. E. Clark, and J. R. Morton Operative Technique, Paraplegia, and Mortality After Blunt Traumatic Aortic Injury Arch Surg, April 1, 2002; 137(4): 434 - 438. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Kazui, C. C. Miller III, and H. J. Safi Spinal cord protection during descending aortic aneurysm repair Ann. Thorac. Surg., March 1, 2002; 73(3): 1023 - 1023. [Full Text] [PDF]
|
|
|
|
|
|
A. L. Estrera, C. C. Miller III, and H. J. Safi Spinal cord protection during descending aortic aneurysm repair: Reply Ann. Thorac. Surg., March 1, 2002; 73(3): 1023 - 1024. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
