HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Search for Related Content Related Collections Related Article

Ann Thorac Surg 1997;63:35-36
© 1997 The Society of Thoracic Surgeons

---

Discussion

Discussion

The first 20% of the full text of this article appears below.

See also page 28.

DR NICHOLAS T. KOUCHOUKOS (St. Louis, MO):

Doctor Coselli and his associates have demonstrated in their large series of patients undergoing resection of thoracoabdominal aortic aneurysms that the presence of aortic dissection is not associated with a higher risk for the development of spinal cord ischemic injury (paraplegia or paraparesis) than aneurysms that are not associated with dissection. They indicate that this experience differs from virtually all, although not all, previously reported series where the incidence of spinal cord ischemic injury has been higher among patients with aortic dissection. After reviewing Dr Coselli and associates' data, it is difficult to attribute these improved results to any single intervention or alteration in technique. During the study interval, which encompasses almost 10 years, three general techniques were used: simple aortic clamping in 81%; atriodistal bypass in 18%; and hypothermic circulatory arrest in 1%. Intravenous heparin was used in the most recent 388 patients. Permissive mild hypothermia occurred in an unspecified number of patients. Fifty-nine percent of the patients had reattachment of intercostal arteries. With the exception of intercostal artery reattachment, these other variables were not entered into the univariate or multivariate analyses to determine their significance as predictors for the development of paraplegia and paraparesis. Year of operation was not examined as a predictive variable. Atriodistal bypass was generally reserved for patients thought to be at high risk for distal ischemic complications, that is those with type I and type II aneurysms, aortic dissection, and Marfan's syndrome, although it was not applied to all patients in these categories.

At the meeting of this Society last year, my colleagues . . . [Full Text of this Article]

Related Article

Paraplegia After Thoracoabdominal Aortic Aneurysm Repair: Is Dissection a Risk Factor?

Joseph S. Coselli, Scott A. LeMaire, Luiz Poli de Figueiredo, and Randall P. Kirby
Ann. Thorac. Surg. 1997 63: 28-36. [Abstract] [Full Text]

This article has been cited by other articles:

				W. R. Chitwood Jr. and L. W. Nifong Minimally Invasive and Robotic Valve Surgery Card. Surg. Adult, January 1, 2003; 2(2003): 1075 - 1092. [Full Text]