title: Staged Hybrid Repair to Reduce the Risk of Spinal Cord Ischemia After Extensive Thoracic Aortic Aneurysm Repair.
abstract: We hypothesized that staged repair of extensive thoracic aneurysms might mitigate the incidence and severity of spinal ischemia by facilitating structural remodeling of the spinal cord vasculature. Staged hybrid repair (in two or three stages) was undertaken in 7 patients with extensive thoracic aortic aneurysms. The 30-day mortality and spinal ischemia rates were 0%. The conceptual basis of staging extensive aortic repairs is the maintenance of adequate flow to a sufficient number of spinal arteries and that spinal perfusion is preserved during the early postoperative period when the patient is most vulnerable to hypotension, by deliberately allowing interval distal type I endoleak.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Hôpital A de Villeneuve, Montpellier, France. Electronic address: ludoviccanaud@hotmail.com.
authors.forename: Ludovic
authors.initials: L
authors.lastname: Canaud
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Hôpital A de Villeneuve, Montpellier, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Gandet
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Hôpital A de Villeneuve, Montpellier, France.
authors.forename: Baris Ata
authors.initials: BA
authors.lastname: Ozdemir
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Hôpital A de Villeneuve, Montpellier, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: D'Annoville
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Hôpital A de Villeneuve, Montpellier, France.
authors.forename: Charles
authors.initials: C
authors.lastname: Marty-Ané
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Hôpital A de Villeneuve, Montpellier, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Alric
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017545:Aortic Aneurysm, Thoracic / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D001027:Aortography; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020760:Spinal Cord Ischemia / Q000209:etiology / Q000517:prevention & control*; D013997:Time Factors; D014057:Tomography, X-Ray Computed