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Left atrial femoral bypass and cerebrospinal fluid drainage decreases neurologic complications in repair of descending and thoracoabdominal aortic aneurysms

Left atrial femoral bypass and cerebrospinal fluid drainage decreases neurologic complications in... This study was undertaken to evaluate the role of cerebrospinal fluid (CSF) drainage and left atrial to femoral artery (LAFA) bypass in preventing postoperative neurologic complications for patients who had undergone descending and thoracoabdominal aortic aneurysm (TAAA) repair. LAFA bypass and CSF drainage were used as adjuncts in the treatment of 8 patients with descending and 13 patients with TAAAs (December 1999 to March 2000). LAFA bypass was established with the use of a centrifugal Biomedicus pump. Distal flows were maintained between 1.5 and 2.5 L/min during the procedures. Mean LAFA bypass time was 40 (range, 21 to 60 min). The CSF pressure was kept below 10–12 mmHg during the operations and for the first 72 hr postoperatively. All patients received heparin (1 mg/kg), which was reversed at the completion of the procedure. Passive hypothermia (rectal temperature: 32‡–34‡C) was used in all cases. All patent T8-L1 intercostal arteries were reattached to the graft. There were 13 men and 8 women. The median age was 56 years (range, 49 to 78). Chronic aortic dissection was the cause of the aneurysm in 9 patients (43%), trauma in 1 patient (5%), and medial degeneration in 11 patients (52%). There were four type I (19%), four type II (19%), and five type III (24%) TAAA. In eight patients (38%) the entire descending thoracic aorta was aneurysmal. Our results showed that the use of CSF drainage and LAFA bypass prevents paraplegia/paraparesis after repair of thoracoabdominal and descending thoracic aneurysms. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Annals of Vascular Surgery Springer Journals

Left atrial femoral bypass and cerebrospinal fluid drainage decreases neurologic complications in repair of descending and thoracoabdominal aortic aneurysms

Plestis, K.; Nair, D.; Russo, M.; Gold, J.
Annals of Vascular Surgery , Volume 15 (1) – Aug 26, 2007
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References (22)

Publisher
Springer Journals
Copyright
Copyright © 2000 by Annals of Vascular Surgery Inc
Subject
Medicine & Public Health; Abdominal Surgery
ISSN
0890-5096
eISSN
1615-5947
DOI
10.1007/BF02693800
Publisher site
See Article on Publisher Site

Abstract

This study was undertaken to evaluate the role of cerebrospinal fluid (CSF) drainage and left atrial to femoral artery (LAFA) bypass in preventing postoperative neurologic complications for patients who had undergone descending and thoracoabdominal aortic aneurysm (TAAA) repair. LAFA bypass and CSF drainage were used as adjuncts in the treatment of 8 patients with descending and 13 patients with TAAAs (December 1999 to March 2000). LAFA bypass was established with the use of a centrifugal Biomedicus pump. Distal flows were maintained between 1.5 and 2.5 L/min during the procedures. Mean LAFA bypass time was 40 (range, 21 to 60 min). The CSF pressure was kept below 10–12 mmHg during the operations and for the first 72 hr postoperatively. All patients received heparin (1 mg/kg), which was reversed at the completion of the procedure. Passive hypothermia (rectal temperature: 32‡–34‡C) was used in all cases. All patent T8-L1 intercostal arteries were reattached to the graft. There were 13 men and 8 women. The median age was 56 years (range, 49 to 78). Chronic aortic dissection was the cause of the aneurysm in 9 patients (43%), trauma in 1 patient (5%), and medial degeneration in 11 patients (52%). There were four type I (19%), four type II (19%), and five type III (24%) TAAA. In eight patients (38%) the entire descending thoracic aorta was aneurysmal. Our results showed that the use of CSF drainage and LAFA bypass prevents paraplegia/paraparesis after repair of thoracoabdominal and descending thoracic aneurysms.

Journal

Annals of Vascular Surgery – Springer Journals

Published: Aug 26, 2007

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