Prevention of paraplegia associated with resection of extensive thoracic aneurysms
A. Wakabayashi and J. E. Connolly
A review of the literature suggests that paraplegia associated with
thoracic aortic surgery is preventable if intraoperative hypotension is
eliminated, the distal aorta perfused adequately, and the intercostal
arteries below T-8 level preserved. A surgical technique has been developed
that leaves the posterior aortic wall, preserving the intercostal arteries
below the level of T-8, and interspersing a diagonally tailored prosthesis
with the aid of left atrial-to-femoral arterial bypass without
heparinization. Seven patients with extensive aneurysms involving the
entire descending thoracic aorta were operated on successfully by this
technique without neurological complications.
