HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Lars G. Svensson Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Svensson, L. G. Search for Related Content PubMed PubMed Citation Articles by Svensson, L. G.

J Thorac Cardiovasc Surg 1996;112:1455-1461
© 1996 Mosby, Inc.

SURGERY FOR ACQUIRED HEART DISEASE

INTRAOPERATIVE IDENTIFICATION OF SPINAL CORD BLOOD SUPPLY DURING REPAIRS OF DESCENDING AORTA AND THORACOABDOMINAL AORTA

From the Center for Aortic Surgery and the Department of Thoracic and Cardiovascular Surgery, Lahey-Hitchcock Clinic, Burlington, Mass.

Received for publication May 6, 1996 Revisions requested July 1, 1966; revisions received August 5, 1996 Accepted for publication August 8, 1996 Address for reprints: Lars G. Svensson, MD, PhD, Director, Center for Aortic Surgery, Department of Thoracic and Cardiovascular Surgery, Lahey Hitchcock Clinic, 41 Mall Rd., Burlington, MA 01805.

Abstract

Objective: The aim was to intraoperatively identify the spinal cord blood supply and shorten the aortic crossclamp time. Methods: A platinum electrode was placed intrathecally by lumbar puncture alongside the spinal cord. After the aorta was crossclamped, hydrogen in a saline solution was injected into the aorta and, if it was shown that the segment supplied the spinal cord and there were multiple arteries, then these were individually injected. The repair was performed by a sequential segmental method as described previously. Results: Postoperatively, highly selective angiography was used to confirm that reattached intercostal arteries supplied the spinal cord. The technique was accurrate in all patients. Five spinal cord perfusion patterns were noted: (1) direct, (2) collateral, (3) no direct supply from segment tested, (4) from atriofemoral bypass, and (5) occluded reattached intercostals. When no response was obtained or no further testing was required (n = 8), testing time was 4.2 minutes and crossclamp time 41.9 minutes. When multiple segmental arteries required further testing, the mean testing time was 10.4 minutes and crossclamp time 58.5 minutes, including reattachment of intercostal vessels (p = not significant). Conclusion: Preliminary findings indicate that this method is a safe research technique, can detect radicular arteries, and may reduce the time for aortic crossclamping if no vessels are identified as supplying the spinal cord. (J THORACCARDIOVASCSURG1996;112:1455-61)

This article has been cited by other articles:

				R.J. Nijenhuis, M. Mull, J.T. Wilmink, A.K. Thron, and W.H. Backes MR Angiography of the Great Anterior Radiculomedullary Artery (Adamkiewicz Artery) Validated by Digital Subtraction Angiography AJNR Am. J. Neuroradiol., August 1, 2006; 27(7): 1565 - 1572. [Abstract] [Full Text] [PDF]

				H. Hyodoh, N. Kawaharada, H. Akiba, M. Tamakawa, K. Hyodoh, J. Fukada, K. Morishita, and M. Hareyama Usefulness of Preoperative Detection of Artery of Adamkiewicz with Dynamic Contrast-enhanced MR Angiography Radiology, September 1, 2005; 236(3): 1004 - 1009. [Abstract] [Full Text] [PDF]

				N. Kawaharada, K. Morishita, H. Hyodoh, Y. Fujisawa, J. Fukada, Y. Hachiro, Y. Kurimoto, and T. Abe Magnetic resonance angiographic localization of the artery of Adamkiewicz for spinal cord blood supply Ann. Thorac. Surg., September 1, 2004; 78(3): 846 - 851. [Abstract] [Full Text] [PDF]

				M. Schepens, K. Dossche, W. Morshuis, R. Heijmen, E. van Dongen, H. ter Beek, H. Kelder, and E. Boezeman Introduction of adjuncts and their influence on changing results in 402 consecutive thoracoabdominal aortic aneurysm repairs Eur. J. Cardiothorac. Surg., May 1, 2004; 25(5): 701 - 707. [Abstract] [Full Text] [PDF]

				K. Yoshioka, H. Niinuma, A. Ohira, K. Nasu, T. Kawakami, M. Sasaki, and K. Kawazoe MR Angiography and CT Angiography of the Artery of Adamkiewicz: Noninvasive Preoperative Assessment of Thoracoabdominal Aortic Aneurysm RadioGraphics, September 1, 2003; 23(5): 1215 - 1225. [Abstract] [Full Text] [PDF]

				H. S. Maniar, T. M. Sundt III, S. M. Prasad, C. M. Chu, C. J. Camillo, M. R. Moon, B. G. Rubin, and G. A. Sicard Delayed paraplegia after thoracic and thoracoabdominal aneurysm repair: a continuing risk Ann. Thorac. Surg., January 1, 2003; 75(1): 113 - 120. [Abstract] [Full Text] [PDF]

				T. Miyairi, Y. Kotsuka, M. Ezure, M. Ono, T. Morota, H. Kubota, K. Shibata, K. Ueno, and S. Takamoto Open stent-grafting for aortic arch aneurysm is associated with increased risk of paraplegia Ann. Thorac. Surg., July 1, 2002; 74(1): 83 - 89. [Abstract] [Full Text] [PDF]

				N. Kawaharada, K. Morishita, J. Fukada, A. Yamada, S. Muraki, H. Hyodoh, and T. Abe Thoracoabdominal or descending aortic aneurysm repair after preoperative demonstration of the Adamkiewicz artery by magnetic resonance angiography Eur. J. Cardiothorac. Surg., June 1, 2002; 21(6): 970 - 974. [Abstract] [Full Text] [PDF]

				H. Ohuchi, K. Ueda, S. Kyo, Y. Yokote, H. Tanabe, H. Hojo, H. Ohuchi, K. Ueda, S. Kyo, Y. Yokote, et al. Continuous Selective Cold Perfusion in Thoracoabdominal Aneurysm Repair Asian Cardiovasc Thorac Ann, September 1, 2000; 8(3): 212 - 215. [Abstract] [Full Text] [PDF]

				M. K. Heinemann, F. Brassel, T. Herzog, C. Dresler, H. Becker, and H. G. Borst The Role of Spinal Angiography in Operations on the Thoracic Aorta: Myth or Reality? Ann. Thorac. Surg., February 1, 1998; 65(2): 346 - 351. [Abstract] [Full Text] [PDF]