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Effect of aorta-iliac bypass total thoracoabdominal aorta aneurysm repair to spinal cord function / 中华外科杂志
Chinese Journal of Surgery ; (12): 380-383, 2016.
Article in Chinese | WPRIM | ID: wpr-349190
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the effect of aorta-iliac bypass total thoracoabdominal aorta aneurysm repair to spinal cord function.</p><p><b>METHODS</b>This was a prospective study. From June 2014 to April 2015, 31 patients underwent total thoracoabdominal aorta aneurysm repair were treated with aorta-iliac bypass technique. There were 23 male and 8 female patients with a mean age of (36±12) years. A 4-branched tetrafurcate graft was used. The aorta-iliac bypass was established, then distal descending aorta was perfused in a retrograde fashion via bypass graft. Thoracic and abdominal aorta were replaced in a staged fashion. Evoked potentials (EP) monitoring was adopted to assess the spinal cord ischemia throughout the procedure. The intraoperative evoked potentials results, clinical outcomes and follow-up results of this technique were evaluated.</p><p><b>RESULTS</b>The EP wave disappeared after proximal descending aorta clamped and gradually recovered after the patent segmental arteries reattached. Motor evoked potentials disappeared for (56±18) minutes, somatosensory evoked potentials disappeared for (50±19) minutes. The EP wave was restored to normal at the end of operation in all cases. The somatosensory evoked potentials remained unchanged in 2 cases (false negative). One case died after operation. There were acute kidney dysfunction in 3 cases, and pulmonary haemorrhage in 1 case. No spinal cord injure occurred. The median follow-up after operation was 8 months (ranging from 1 to 11 months). There was no delayed neurologic deficit or relative death.</p><p><b>CONCLUSIONS</b>There is a transient function loss of spinal cord during the aorta-iliac bypass total thoracoabdominal aorta aneurysm repair. But the process is reversible. The technique of the aorta-iliac bypass is practicable.</p>
Subject(s)
Full text: Available Index: WPRIM (Western Pacific) Main subject: Aorta, Abdominal / Spinal Cord / General Surgery / Vascular Surgical Procedures / Prospective Studies / Aortic Aneurysm, Thoracic / Aortic Aneurysm, Abdominal / Evoked Potentials, Motor / Evoked Potentials, Somatosensory Type of study: Observational study Limits: Adult / Female / Humans / Male Language: Chinese Journal: Chinese Journal of Surgery Year: 2016 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Aorta, Abdominal / Spinal Cord / General Surgery / Vascular Surgical Procedures / Prospective Studies / Aortic Aneurysm, Thoracic / Aortic Aneurysm, Abdominal / Evoked Potentials, Motor / Evoked Potentials, Somatosensory Type of study: Observational study Limits: Adult / Female / Humans / Male Language: Chinese Journal: Chinese Journal of Surgery Year: 2016 Type: Article