Spinal cord injury following aortic arch replacement

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Vascular Surgery

Background:

• Postoperative spinal cord injury is a serious complication following aortic arch replacement surgery.
• Understanding the risk factors is crucial for patient management and improving outcomes.

Purpose of the Study:

• To identify predictors of spinal cord injury after aortic arch replacement.
• To analyze the incidence and associated risk factors for this complication.

Main Methods:

• A cohort of 254 patients undergoing aortic arch replacement was analyzed.
• Risk factors were assessed using multivariable logistic regression.
• Atherothrombotic lesions were identified via computed tomography.

Main Results:

• The incidence of permanent spinal cord injury was 1.97% and transient was 2.36%.
• Key predictors identified include frozen elephant trunk technique, prior aortic repair, proximal atherothrombotic aorta, COPD, and advanced age.
• The model demonstrated high predictive accuracy (AUC 0.93).

Conclusions:

• Spinal cord injury is a significant concern after aortic arch replacement.
• Comprehensive aortic assessment and awareness of identified risk factors are essential for prevention and management.