Reversal of paralysis and visceral ischemia after thoracic aortic ligation for infection via extra anatomic ascending aorta to infarenal aorta bypass graft

Journal of Cardiothoracic Surgery

Michael R Go⁴  Galina T Dimitrova²  Lamia Buohliqah³  Haytham Elgharably¹  Hamdy Awad² 

[1] Department of Thoracic & Cardiovascular Surgery, Cleveland Clinic Foundation, 9500 Euclid Avenue (J4-133), Cleveland 44195, OH, USA;Department of Anesthesiology, The Ohio State University Wexner Medical Center, 410 West 10th Avenue, Columbus 43210, OH, USA;Department Department of Otolaryngology - Head & Neck Surgery, 4000 Eye and Ear Institute, 915 Olentangy River Road, Columbus 43212, OH, USA;Department of Surgery, Division of Vascular Diseases and Surgery, The Ohio State University Wexner Medical Center, 376 West 10th Avenue, Columbus 43210, OH, USA

关键词: Perfusion;    Stent-graft;    Infection;    Aorta;    Paralysis;   

Others  :  1152117
DOI  :  10.1186/s13019-014-0142-4

 received in 2014-05-11, accepted in 2014-08-04,  发布年份 2014

【 摘 要 】

Surgical management of acute aortic infection is challenging, including excision of the infected segment and reconstruction either through extra-anatomical bypass or in situ graft replacement with higher risk of re-infection. Here in, we present a case of delayed paralysis developed after an extra-anatomic (axillary-bifemoral) bypass of infected thoracic aorta in a 51 year old Caucasian male. Reversal of paralysis was successfully achieved via larger extra-anatomical ascending aorta to infra-renal aorta bypass and cerebrospinal fluid (CSF) drainage.

【 授权许可】

   
2014 Awad et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Heyer KS, Modi P, Morasch MD, Matsumura JS, Kibbe MR, Pearce WH, Resnick SA, Eskandari MK: Secondary infections of thoracic and abdominal aortic endografts. J Vasc Interv Radiol 2009, 20:173-179.
• [2]Cernohorsky P, Reijnen MM, Tielliu IF, van Sterkenburg SM, van den Dungen JJ, Zeebregts CJ: The relevance of aortic endograft prosthetic infection. J Vasc Surg 2011, 54:327-333.
• [3]Coselli JS, Koksoy C, LeMaire SA: Management of thoracic aortic graft infections. Ann Thorac Surg 1999, 67:1990-1993. discussion 1997¿1998
• [4]Sakurai M, Hayashi T, Abe K, Sadahiro M, Tabayashi K: Delayed and selective motor neuron death after transient spinal cord ischemia: a role of apoptosis? J Thorac Cardiovasc Surg 1998, 115:1310-1315.
• [5]Diener H, Hellwinklel O, Carpenter S, Larena-Avellaneda A, Debus ES: Homografts and extra-anatomical reconstructions for infected vascular grafts. J Cardiovasc Surg 2014, 55:217-223.
• [6]Puchakayala MR, Lau WC: Descending thoracic aortic aneurysms. Contin Educ Anaesth Crit Care Pain 2006, 6:54-59.
• [7]Keyhani K, Miller CC 3rd, Estrera AL, Wegryn T, Sheinbaum R, Safi HJ: Analysis of motor and somatosensory evoked potentials during thoracic and thoracoabdominal aortic aneurysm repair. J Vasc Surg 2009, 49:36-41.
• [8]Awad H, Elgharably H, Popovich PG: Role of induced hypothermia in thoracoabdominal aortic aneurysm surgery. Ther Hypothermia Temperature Manage 2012, 2:119-137.