PMID: 3767513Oct 1, 1986Paper

Spinal cord ischemia following operation for traumatic aortic transection

The Annals of Thoracic Surgery
M A MarvastiF B Parker

Abstract

The danger of irreversible ischemic damage to the spinal cord following repair of traumatic aortic rupture has prompted many techniques designed to decrease this risk. Surgical repair was performed on 41 consecutive patients, using four different methods. These included: group 1 (15 patients), left-heart pump bypass with systemic administration of heparin; group 2 (7 patients), heparinized shunt from the ascending aorta to the descending aorta or to the femoral artery; group 3 (14 patients), heparinized shunt from the left ventricle to the aorta or femoral artery; group 4 (5 patients), aortic cross-clamp only. Spinal cord ischemia was not seen in groups 1 or 2, but paraparesis or paraplegia developed in 4 patients in group 3. Severe shock accompanied rupture in all patients in group 4, and no time was taken for a shunt or bypass. Four of the 7 deaths occurred in the operating room in patients who had arrived moribund and in severe shock. In our experience, shunts from the left ventricle to the aorta have failed to protect the spinal cord against ischemia. Left-heart bypass or aorta-to-aorta shunts are now our procedure of choice.

References

May 1, 1985·The Annals of Thoracic Surgery·J T SturmJ F Perry
Jun 1, 1985·The Annals of Thoracic Surgery·J W Pate
Aug 1, 1982·Paraplegia·C Lynch, S I Weingarden
Oct 1, 1980·The Annals of Thoracic Surgery·H NajafiD Monson

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Citations

Jun 1, 2007·Seminars in Interventional Radiology·Simon J McPherson
Jun 1, 1988·Annals of Surgery·W H MerrillH W Bender
Apr 11, 2009·The Journal of Trauma·L Leon Dent, Arthur Lee
Nov 1, 1991·Current Problems in Surgery·P N Symbas
Jul 1, 1990·The Annals of Thoracic Surgery·I RabinskyR B Wagner
Jun 1, 1990·Chest·A J DelRossiR K Spence
Nov 1, 1991·The Australian and New Zealand Journal of Surgery·A A XabregasJ A Feint
Dec 1, 1990·Arquivos de neuro-psiquiatria·S M de SouzaP R Bittencourt
Dec 9, 1997·The Journal of Trauma·E J FrickS A Nastasee

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