A Case of Emergency Ascending Aorta Replacement for Paraplegia Caused by Stanford Type A Acute Aortic Dissection

(Department of Cardiovascular Surgery, Social Insurance Kinan Hospital, Tanabe, Japan)

Ryohei Matsuura Nobuo Sakagoshi Kenta Masada
Yasuhisa Shimazaki
We report a rare case of type A acute aortic dissection with paraplegia which was cured immediately after an emergency operation. A 79-year-old woman was transferred to our institution with sudden back pain and paraplegia. Computed tomographic scans revealed a cardiac tamponade with an acute type A aortic dissection. She went into shock soon after arrival, and about 4 hours from onset we performed an emergency replacement of the ascending aorta. Three hours after the operation, her neurological deficit gradually resolved and could walk by postoperative day 3. This case suggests that early restoration of the blood flow to the spinal cord is mandatory to relieve paraplegia caused by type A aortic dissection.
  Jpn. J. Cardiovasc. Surg. 40:236-239(2011)

Keywords:type A acute aortic dissection, paraplegia, spinal ischemia, emergency operation, replacement of the ascending aorta