title: [Effect of aorta-iliac bypass total thoracoabdominal aorta aneurysm repair to spinal cord function].
abstract: OBJECTIVE
  To evaluate the effect of aorta-iliac bypass total thoracoabdominal aorta aneurysm repair to spinal cord function.
  
  
  METHODS
  This was a prospective study. From June 2014 to April 2015, 31 patients underwent total thoracoabdominal aorta aneurysm repair were treated with aorta-iliac bypass technique. There were 23 male and 8 female patients with a mean age of (36±12) years. A 4-branched tetrafurcate graft was used. The aorta-iliac bypass was established, then distal descending aorta was perfused in a retrograde fashion via bypass graft. Thoracic and abdominal aorta were replaced in a staged fashion. Evoked potentials (EP) monitoring was adopted to assess the spinal cord ischemia throughout the procedure. The intraoperative evoked potentials results, clinical outcomes and follow-up results of this technique were evaluated.
  
  
  RESULTS
  The EP wave disappeared after proximal descending aorta clamped and gradually recovered after the patent segmental arteries reattached. Motor evoked potentials disappeared for (56±18) minutes, somatosensory evoked potentials disappeared for (50±19) minutes. The EP wave was restored to normal at the end of operation in all cases. The somatosensory evoked potentials remained unchanged in 2 cases (false negative). One case died after operation. There were acute kidney dysfunction in 3 cases, and pulmonary haemorrhage in 1 case. No spinal cord injure occurred. The median follow-up after operation was 8 months (ranging from 1 to 11 months). There was no delayed neurologic deficit or relative death.
  
  
  CONCLUSIONS
  There is a transient function loss of spinal cord during the aorta-iliac bypass total thoracoabdominal aorta aneurysm repair. But the process is reversible. The technique of the aorta-iliac bypass is practicable.
authors.affiliation: Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
authors.forename: Yuyin
authors.initials: Y
authors.lastname: Duan
authors.forename: Jun
authors.initials: J
authors.lastname: Zheng
authors.forename: Xudong
authors.initials: X
authors.lastname: Pan
authors.forename: Junming
authors.initials: J
authors.lastname: Zhu
authors.forename: Yongmin
authors.initials: Y
authors.lastname: Liu
authors.forename: Yipeng
authors.initials: Y
authors.lastname: Ge
authors.forename: Lijian
authors.initials: L
authors.lastname: Cheng
authors.forename: Lizhong
authors.initials: L
authors.lastname: Sun
mesh_terms: D000328:Adult; D001012:Aorta, Abdominal / Q000601:surgery; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D019054:Evoked Potentials, Motor; D005073:Evoked Potentials, Somatosensory; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013116:Spinal Cord / Q000503:physiopathology*; D014656:Vascular Surgical Procedures / Q000009:adverse effects*