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Ann Thorac Surg 2004;78:851-852
© 2004 The Society of Thoracic Surgeons

Invited commentary

Section of Cardiothoracic Surgery, and Section of Magnetic Resonance Imaging, Yale University School of Medicine, 333 Cedar St New Haven, CT 06510, USA

john.elefteriades@yale.edu
jeffrey.weinreb@yale.edu

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

There has been great difference of opinion regarding the importance of reimplanting intercostal arteries. Some aortic surgeons believe this is essential, while others, such as Griepp and colleagues [1], believe that reimplantation makes no clinical difference in paraplegia rates. This dichotomy is based on two schools of thought:

• The Adamkiewicz school believes that a single artery, usually arising from the T8 to L2 segments, provides segmental blood flow to the lower spinal cord, compensating for the discontinuity in the anterior spinal artery.
  
• The "gas tank" school maintains that no single artery is so important, but rather it is the total amount of blood flow through all intercostal and lumbar arteries that determines adequacy of cord perfusion.
  

For those who believe in the reimplantation of crucial spinal arteries, the identification of the spinal artery or arteries that . . . [Full Text of this Article]

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Ann. Thorac. Surg. 2004 78: 846-851. [Abstract] [Full Text] [PDF]