Spinal cord protection during thoracoabdominal aortic replacement: Spinal cord perfusion maintenance

Gaku Uchino, Keiji Yunoki, Naoya Sakoda, Shigeru Hattori, Takuya Kawabata, Munehiro Saiki, Yasufumi Fujita, Kunikazu Hisamochi, Hideo Yoshida

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

OBJECTIVES: Spinal cord protection during thoracoabdominal aortic surgery is challenging for surgeons. We performed thoracoabdominal replacement using a strategy for maintaining spinal cord perfusion pressure. Here, we report our experience with this procedure and the surgical outcomes. METHODS: Between January 2000 and December 2014, 130 patients [male: 91 (74.6%), female: 39 (25.4%); mean age: 66.6 ± 12.8 years] underwent thoracoabdominal replacement using cardiopulmonary bypass at Hiroshima Shimin Hospital, Japan. The surgical outcomes of these patients were analysed. RESULTS: The in-hospital mortality rate of all patients was 2.5%. The incidence of postoperative paraplegia was 3.8%. Aortic event-free survival rates at 1, 3 and 5 years were 98.2%, 93.9% and 80.7%, respectively. CONCLUSIONS: The present study suggests that our strategy for maintaining spinal cord perfusion pressure provides acceptable outcomes.

Original languageEnglish
Pages (from-to)708-713
Number of pages6
JournalInteractive Cardiovascular and Thoracic Surgery
Volume24
Issue number5
DOIs
Publication statusPublished - May 1 2017
Externally publishedYes

Fingerprint

Spinal Cord
Perfusion
Maintenance
Pressure
Paraplegia
Hospital Mortality
Cardiopulmonary Bypass
Disease-Free Survival
Japan
Survival Rate
Mortality
Incidence
Surgeons

Keywords

  • Intercostal artery reconstruction
  • Paraplegia
  • Spinal ischaemia
  • Thoracoabdominal replacement

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Spinal cord protection during thoracoabdominal aortic replacement : Spinal cord perfusion maintenance. / Uchino, Gaku; Yunoki, Keiji; Sakoda, Naoya; Hattori, Shigeru; Kawabata, Takuya; Saiki, Munehiro; Fujita, Yasufumi; Hisamochi, Kunikazu; Yoshida, Hideo.

In: Interactive Cardiovascular and Thoracic Surgery, Vol. 24, No. 5, 01.05.2017, p. 708-713.

Research output: Contribution to journalArticle

Uchino, G, Yunoki, K, Sakoda, N, Hattori, S, Kawabata, T, Saiki, M, Fujita, Y, Hisamochi, K & Yoshida, H 2017, 'Spinal cord protection during thoracoabdominal aortic replacement: Spinal cord perfusion maintenance', Interactive Cardiovascular and Thoracic Surgery, vol. 24, no. 5, pp. 708-713. https://doi.org/10.1093/icvts/ivw450
Uchino, Gaku ; Yunoki, Keiji ; Sakoda, Naoya ; Hattori, Shigeru ; Kawabata, Takuya ; Saiki, Munehiro ; Fujita, Yasufumi ; Hisamochi, Kunikazu ; Yoshida, Hideo. / Spinal cord protection during thoracoabdominal aortic replacement : Spinal cord perfusion maintenance. In: Interactive Cardiovascular and Thoracic Surgery. 2017 ; Vol. 24, No. 5. pp. 708-713.
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AB - OBJECTIVES: Spinal cord protection during thoracoabdominal aortic surgery is challenging for surgeons. We performed thoracoabdominal replacement using a strategy for maintaining spinal cord perfusion pressure. Here, we report our experience with this procedure and the surgical outcomes. METHODS: Between January 2000 and December 2014, 130 patients [male: 91 (74.6%), female: 39 (25.4%); mean age: 66.6 ± 12.8 years] underwent thoracoabdominal replacement using cardiopulmonary bypass at Hiroshima Shimin Hospital, Japan. The surgical outcomes of these patients were analysed. RESULTS: The in-hospital mortality rate of all patients was 2.5%. The incidence of postoperative paraplegia was 3.8%. Aortic event-free survival rates at 1, 3 and 5 years were 98.2%, 93.9% and 80.7%, respectively. CONCLUSIONS: The present study suggests that our strategy for maintaining spinal cord perfusion pressure provides acceptable outcomes.

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