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Preoperative and Postoperative Arterial Adaptation in Patients with Acute Aortic Dissection
Marian Burysz1,2,3,4, Mariusz Kowalewski3,5,6, Natalia Piekuś-Słomka7
1Department of Cardiac Surgery, Regional Specialist Hospital, 86-300 Grudziądz, Poland.
Journal of Clinical Medicine
|December 17, 2024
Summary
In patients undergoing aortic repair for dissection, specific arteries supplying the spinal cord were larger preoperatively. These findings suggest the internal thoracic and supreme intercostal arteries may be crucial for spinal cord blood supply.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Neurology
Background:
- Spinal cord ischemia is a severe complication following aortic repair.
- Arterial changes during aortic dissection and their post-repair status are not well understood.
Purpose of the Study:
- To compare spinal-cord-supplying arteries in patients with acute aortic dissection (pre- and post-operatively) versus controls without dissection.
- To investigate the role of specific arteries in spinal cord perfusion during aortic dissection and repair.
Main Methods:
- Retrospective analysis of contrast-enhanced CT scans from 25 aortic dissection patients (frozen elephant trunk procedure) and 25 control patients (transcatheter aortic valve replacement).
- Detailed analysis of aortic branches identified in literature as potential spinal cord blood supply sources.
Main Results:
- Preoperative diameters of left internal thoracic, left musculophrenic, and left/right supreme intercostal arteries were significantly larger than postoperative measurements.
- Preoperative diameters of left vertebral, right internal thoracic, left lateral thoracic, and left common iliac arteries were significantly larger in dissection patients compared to controls.
Conclusions:
- Internal thoracic arteries and supreme intercostal arteries may play a vital role in compensating for spinal cord blood supply during aortic dissection.
- These findings highlight potential collateral pathways for spinal cord perfusion in aortic dissection patients.
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