Clamp and sew techniques in thoracoabdominal aortic surgery using naloxone and CSF drainage.
Surgical repair of thoracoabdominal (TAA) and thoracic aneurysm is challenging, with the potentials for high morbidity and mortality. There is no standardized operative approach. Operative management of TAA consists of simple clamp-and-sew techniques with adjuncts, cerebrospinal fluid (CSF) drainage, naloxone administration, and intraoperative hypothermia, to protect the spinal cord. The use of CSF drainage and naloxone administration has reduced paraplegia to 3.4%, compared with 21% when none of these adjunctive spinal cord measures were used. The authors discuss their operative strategy, surgical technique, and results at the University of Wisconsin Hospital and Clinics.
Tefera
G
G
University of Wisconsin Medical School, Department of Surgery, Madison 53792, USA.
Acher
C W
CW
Wynn
M M
MM
D001012:Aorta, Abdominal / Q000601:surgery; D001013:Aorta, Thoracic / Q000601:surgery; D001014:Aortic Aneurysm / Q000601:surgery*; D002555:Cerebrospinal Fluid; D003250:Constriction; D004322:Drainage; D006801:Humans; D009270:Naloxone / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D011446:Prospective Studies; D013536:Suture Techniques; D014656:Vascular Surgical Procedures / Q000379:methods
D009292:Narcotic Antagonists; D009270:Naloxone