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Importance of Selective Cerebral Perfusion（SCP）to Prevent Intraoperative Ischemic Spinal Cord Injury in Surgical Case of Acute Type A Aortic Dissection
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（Department of Cardiovascular Surgery, Otaru Municipal Medical Center, Otaru, Japan）
| Joji Fukada |
Yukihiko Tamiya |
Yasuaki Fujisawa |
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We report a rare case of surgical treatment for acute type A aortic dissection with expansion of the false lumen. The patient was a 72-year-old man without any motor paresis who underwent total aortic arch replacement with two-vessel perfusion of SCP and mild hypothermic circulatory arrest for the lower half of the body. Postoperatively, the patient had tetraparesis which was more severe than in his lower extremities, whereas the sensory function was preserved. It was assumed that the anterior horns of the spinal cord were injured longitudinally due to insufficient blood flow of the anterior spinal artery through the SCP. This case suggests that three-vessel perfusion of SCP is important in surgical treatment for acute type A aortic dissection for the prevention of intraoperative ischemic spinal cord injury.
Jpn. J. Cardiovasc. Surg. 42:59-62（2013）
Keywords：acute type A aortic dissection, ischemic spinal cord injury, selective cerebral perfusion, anterior horn of the spinal cord, anterior spinal artery
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