Hideyuki Shimizu1, Atsuo Mori2, Akihiro Yoshitake3, Tatsuya Yamada4, Hiroshi Morisaki4, Hideyuki Okano5, Ryohei Yozu3. 1. Department of Cardiovascular Surgery, Keio University, Tokyo, Japan shimizu.md@gmail.com. 2. Department of Cardiovascular Surgery, Kawasaki Municipal Hospital, Kanagawa, Japan. 3. Department of Cardiovascular Surgery, Keio University, Tokyo, Japan. 4. Department of Anesthesiology, Keio University, Tokyo, Japan. 5. Department of Physiology, Keio University, Tokyo, Japan.
Abstract
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.
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.
Authors: Daniela Lobenwein; Can Tepeköylü; Radoslaw Kozaryn; Elisabeth J Pechriggl; Mario Bitsche; Michael Graber; Helga Fritsch; Severin Semsroth; Nadia Stefanova; Patrick Paulus; Martin Czerny; Michael Grimm; Johannes Holfeld Journal: J Am Heart Assoc Date: 2015-10-27 Impact factor: 5.501