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[Surgical treatment for thoracoabdominal aortic aneurysm]
Y Hanafusa1, K Okada, T Mimura
1Division of Cardiovascular, Thoracic, and Pediatric Surgery, Kobe University, Graduate School of Medicine, Kobe, Japan.
Kyobu Geka. the Japanese Journal of Thoracic Surgery
|April 10, 2004
Summary
Spinal cord injury is a risk in thoracoabdominal aortic aneurysm (TAAA) repair. Despite protective measures like cerebrospinal fluid drainage, some patients still experience neurological deficits post-surgery.
Area of Science:
- Cardiovascular Surgery
- Neurosurgery
- Vascular Surgery
Context:
- Thoracoabdominal aortic aneurysm (TAAA) repair poses significant risks of spinal cord injury, including paraparesis and paraplegia.
- Effective spinal cord protection strategies are crucial for improving outcomes in TAAA surgery.
Purpose:
- To report the surgical treatment outcomes for TAAA, focusing on postoperative neurological complications.
- To evaluate the efficacy of current spinal cord protection techniques in TAAA repair.
Summary:
- Thirty-three patients underwent TAAA repair between 1999 and 2004, employing spinal cord protection methods such as cerebrospinal fluid drainage (CSFD), distal aortic perfusion, and hypothermia.
- Reconstruction of intercostal or lumbar arteries (Th8-L2) was performed in 25 patients. Six hospital deaths occurred.
- Postoperative spinal cord injury affected 4 patients (1 paraparesis, 3 paraplegia), despite aggressive protective measures.
Impact:
- Current TAAA repair strategies offer acceptable early survival rates.
- Despite advancements, postoperative spinal cord injury remains a concern, highlighting the need for further research into enhanced spinal cord protection methods.