title: Open heart surgery in a paraplegic patient.
abstract: We operated on a patient who had been paraplegic since sustaining a spinal cord injury 11 years ago. We made a reversed L-shaped sternum incision and cannulated all tubes for the cardiopulmonary bypass through a wound window. This provided an excellent surgical view without restricting the patient's upper limbs (needed for wheel chair operation), and recovery was good. Just after surgery, however, it was difficult to control blood pressure and the loss of serum albumin. We believe this is the first report of open-heart surgery undertaken in a paraplegic patient and that the reversed L-shaped incision and careful monitoring of hemodynamics each played an important role in the successful outcome. We hope that this report will help in the treatment of other paraplegic patients who need open-heart surgery.
authors.affiliation: Department of Cardiothoracic Surgery, Saiseikai Suita Hospital, Osaka, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Shimada
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Kawata
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Iwasaki
authors.forename: Hideshi
authors.initials: H
authors.lastname: Itoh
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Kawachi
mesh_terms: D000203:Activities of Daily Living; D002315:Cardiopulmonary Bypass / Q000295:instrumentation / Q000379:methods; D017023:Coronary Angiography; D004322:Drainage / Q000295:instrumentation / Q000379:methods; D004452:Echocardiography; D006338:Heart Neoplasms / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007261:Infusions, Intra-Arterial / Q000295:instrumentation / Q000379:methods; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D009232:Myxoma / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D010264:Paraplegia / Q000150:complications* / Q000523:psychology; D019990:Perioperative Care / Q000379:methods; D011788:Quality of Life; D012559:Schizophrenia / Q000150:complications; D016896:Treatment Outcome