TY - JOUR
T1 - Thoracic and thoracoabdominal aortic repair under regional spinal cord hypothermia
AU - Shimizu, Hideyuki
AU - Mori, Atsuo
AU - Yoshitake, Akihiro
AU - Yamada, Tatsuya
AU - Morisaki, Hiroshi
AU - Okano, Hideyuki
AU - Yozu, Ryohei
N1 - Funding Information:
This work was supported in part by a grant-in-aid for Scientific Research (C) from the Ministry of Education, Culture, Sports, Science and Technology.
PY - 2014/7
Y1 - 2014/7
N2 - OBJECTIVES: Spinal cord deficits are devastating complications after surgery for thoracic and thoracoabdominal aortic aneurysms. We developed a regional spinal cord cooling system using an epidural catheter containing cold saline within an isolated counter-current lumen to prevent such complications and reviewed the clinical results. METHODS: We enrolled 37 patients with thoracic (n = 13) and thoracoabdominal (n = 24) aortic aneurysms that were repaired using the regional spinal cord cooling system under mild hypothermia with a partial femoro-femoral bypass. RESULTS: Although 2 patients died before hospital discharge (hospital mortality, 5.4%), none developed neurological deficits such as paraplegia or paraparesis. CONCLUSIONS: The outcomes of surgery for thoracic and thoracoabdominal aortic aneurysms under regional spinal cord hypothermia using a custom-designed epidural catheter were excellent. Although our patient cohort was small, the results indicate that our technique might help to improve the outcomes of thoracic and thoracoabdominal aortic repair.
AB - OBJECTIVES: Spinal cord deficits are devastating complications after surgery for thoracic and thoracoabdominal aortic aneurysms. We developed a regional spinal cord cooling system using an epidural catheter containing cold saline within an isolated counter-current lumen to prevent such complications and reviewed the clinical results. METHODS: We enrolled 37 patients with thoracic (n = 13) and thoracoabdominal (n = 24) aortic aneurysms that were repaired using the regional spinal cord cooling system under mild hypothermia with a partial femoro-femoral bypass. RESULTS: Although 2 patients died before hospital discharge (hospital mortality, 5.4%), none developed neurological deficits such as paraplegia or paraparesis. CONCLUSIONS: The outcomes of surgery for thoracic and thoracoabdominal aortic aneurysms under regional spinal cord hypothermia using a custom-designed epidural catheter were excellent. Although our patient cohort was small, the results indicate that our technique might help to improve the outcomes of thoracic and thoracoabdominal aortic repair.
KW - Aneurysm
KW - Aortic operation
KW - Cardiopulmonary bypass
KW - Surgery techniques
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U2 - 10.1093/ejcts/ezt574
DO - 10.1093/ejcts/ezt574
M3 - Article
C2 - 24335470
AN - SCOPUS:84903779815
SN - 1010-7940
VL - 46
SP - 40
EP - 43
JO - European Journal of Cardio-thoracic Surgery
JF - European Journal of Cardio-thoracic Surgery
IS - 1
M1 - ezt574
ER -