Risk factors of spinal cord injury after total aortic arch replacement and frozen elephant trunk
10.3760/cma.j.cn112434-20211230-00421
- VernacularTitle:主动脉全弓替换及冷冻象鼻支架术后脊髓损伤的危险因素分析
- Author:
Zhiqiang DONG
1
;
Jie JIANG
;
Hong LIU
;
Jiaxi GU
;
Minghui LI
;
Buqing NI
Author Information
1. 南京医科大学第一附属医院心脏大血管外科，南京 210029
- Keywords:
Aortic dissection;
Spinal cord injury;
Frozen elephant trunk;
Risk factors
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2022;38(10):590-595
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the risk factors of spinal cord injury after FET for ATAAD.Methods:We analyzed perioperative data of 111 patients with ATAAD who underwent FET in the First Affiliated Hospital of Nanjing Medical University from January 2020 to October 2021.Results:Eleven(9.9%)of 111 patients had postoperative spinal cord injury, which showed varying degrees of paralysis or paraplegia. There was no significant difference in age, sex, medical history, cardiopulmonary bypass time, aortic cross-clamping time, circulatory arrest time and FET length between spinal cord injury group and non-spinal cord injury group( P>0.05). Univariate analysis showed that aortic true lumen away from the spinal side( P<0.001) and the number of segmental arteries originating from the true lumen<3 in T9-L3( P<0.001), left subclavian artery involvement( P<0.05) and stent coverage at T8 or beyond( P<0.05) was associated with postoperative spinal cord injury. Multivariate Logistic analysis showed that aortic true lumen away from the spinal side( P<0.001) and the number of segmental arteries originating from the true lumen<3( P<0.001) in T9-L3 and left subclavian artery involvement( P<0.05) were independent risk factors for postoperative spinal cord injury. Conclusion:The pathogenesis of spinal cord injury is complicated. This study suggests that the occurrence of spinal cord injury is significantly related to aortic true lumen away from the spinal side and the number of segmental arteries originating from the true lumen<3 in T9-L3 and left subclavian artery involvement. It is of great clinical significance to identify the high risk factors of postoperative spinal cord injury as early as possible.
