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SEP Monitoring During Aortic Surgery

  • R. Trazzi
  • E. Fava
  • A. Ducati
  • E. M. Bortolani
  • M. Cenzato
  • A. Landi
  • L. Seccia
Chapter

Abstract

Surgical procedures requiring temporary occlusion of the descending aorta expose patients to the risk of ischemic injury to the spinal cord. The incidence of complete neurologic lesions complicating the resection of thoracic aortic aneurysms is reported as high as 24% of operated cases, with the greatest risk following operations for acute traumatic aortic rupture and elective resection of extensive thoraco-abdominal aortic lesions2. Neurological complications are less frequent following abdominal aortic aneurysm surgery; Szilagyi et al. 5 reported that the incidence of spinal cord damage was 0.25% in a series of more than three thousand operations. The necessity for ligation and exclusion of multiple intercostal and lumbar vessels during the course of operative repair of lesions, mainly in the thoracic and thoraco-abdominal aorta, may result in the permanent, though inadvertent, interruption of vessels critical for blood supply to the spinal cord. Paraplegia may result. Such catastrophic neurological complications have been, up to now, undetectable during the surgical procedure.

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References

  1. 1.
    Chiappa KH (Ed) (1983) Evoked potentials in clinical medicine. Raven Press Books Ltd, New YorkGoogle Scholar
  2. 2.
    Coles JC, Wilson GJ, Sima AF, Klement P, Tait GA, Williams WG, Baird RJ (1983) Intraoperative management of thoracic aortic aneurysm. J Thorac Cardiovasc Surg 85: 292–299PubMedGoogle Scholar
  3. 3.
    Grundy BL (1985) Intraoperative applications of evoked responses. In: Owen J, Davis H (eds) Evoked potential testing. Grune and Stratton Inc, Orlando, pp 159–212Google Scholar
  4. 4.
    Svensson LG, Rickards E, Coull A, Rogers G, Fimmel CJ, Hinder RA (1986) Relationship of spinal cord blood flow to vascular anatomy during thoracic aortic cross-clamping and shunting. J Thorac Cardiovasc Surg 91: 71–78PubMedGoogle Scholar
  5. 5.
    Szilagyi DE, Hageman JH, Smith RF, Elliott JP (1978) Spinal cord damage in surgery of the abdominal aorta. Surgery 83: 38–56PubMedGoogle Scholar

Copyright information

© Springer-Verlag Wien 1988

Authors and Affiliations

  • R. Trazzi
    • 1
  • E. Fava
    • 2
  • A. Ducati
    • 3
  • E. M. Bortolani
    • 4
  • M. Cenzato
    • 3
  • A. Landi
    • 3
  • L. Seccia
    • 1
  1. 1.II Chair of AnesthesiologyUniversity of MilanoItaly
  2. 2.CNR Institute Muscle Physiologyc/o University of MilanoItaly
  3. 3.Institute of NeurosurgeryUniversity of MilanoItaly
  4. 4.Institute of General and Cardiovascular SurgeryUniversity of MilanoItaly

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