Home > Journals > The Journal of Cardiovascular Surgery > Past Issues > The Journal of Cardiovascular Surgery 2021 August;62(4) > The Journal of Cardiovascular Surgery 2021 August;62(4):316-25

CURRENT ISSUE
 

JOURNAL TOOLS

eTOC
To subscribe PROMO
Submit an article
Recommend to your librarian
 

ARTICLE TOOLS

Publication history
Reprints
Permissions
Cite this article as
Share

 

REVIEW  CURRENT TREND IN THORACOABDOMINAL AORTIC ANEURYSM SURGERY - PART 2 Freefree

The Journal of Cardiovascular Surgery 2021 August;62(4):316-25

DOI: 10.23736/S0021-9509.21.11783-5

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Spinal cord protection in thoracoabdominal aortic aneurysm surgery: a multimodal approach

Josephina HAUNSCHILD 1, Konstantin VON ASPERN 1, Martin MISFELD 1, 2, 3, 4, 5, Piroze DAVIERWALA 1, Michael A. BORGER 1, Christian D. ETZ 1

1 Department of Cardiac Surgery, Leipzig Heart Center, Leipzig, Germany; 2 Department of Cardiothoracic Surgery, Royal Prince Alfred Hospital, Sydney, Australia; 3 Faculty of Medicine and Health, Central Clinical School, University of Sydney, Sydney, Australia; 4 Institute of Academic Surgery, RPAH, Sydney, Australia; 5 The Baird Institute of Applied Heart and Lung Surgical Research, Sydney, Australia



Spinal cord injury (SCI) is one major complication of open and endovascular thoracic and thoracoabdominal aortic aneurysm repair. Despite numerous neuroprotective adjuncts, the incidence of SCI remains high. This review article discusses established and novel adjuncts for spinal cord protection, including priming and preconditioning of the paraspinal collateral network, intraoperative systemic hypothermia, distal aortic perfusion, motor- and somatosensory evoked potentials and noninvasive cnNIRS monitoring as well as peri- and postoperative drainage of cerebrospinal fluid. Regardless of the positive influence of many of these strategies on neurologic outcome, to date no strategy assures definitive preservation of spinal cord integrity during and after aortic aneurysm repair.


KEY WORDS: Aortic aneurysm; Spinal cord ischemia; Paraplegia

top of page