Delayed-Onset Paraplegia after Type A Dissection Repair

Koji Furukawa	Shuhei Sakaguchi	Katsuya Kawagoe
Masakazu Matsuyama	Mitsuhiro Yano

（Department of Cardiovascular Surgery, Miyazaki Medical Association Hospital＊, Miyazaki, Japan）

We present the case of a 53-year-old man who developed delayed-onset paraplegia after type A dissection repair. He was referred to our hospital with a diagnosis of type A dissection, for which we performed total arch replacement. Although the patient started walking on postoperative day 4, on postoperative day 5, he developed lower limb paraplegia without any precipitating episodes. Computed tomography showed that the false lumen was thrombosed in the upper descending thoracic aorta and hypoperfused in the lower descending thoracic aorta. The cerebrospinal fluid was immediately drained to maintain the spinal pressure at 14 cm H2O for four days. Although the patient began to move his legs immediately after treatment, he remained paraparetic, and was transferred to another rehabilitation hospital on postoperative day 40.

 

Jpn. J. Cardiovasc. Surg. 45:45-48（2016）

Keywords：delayed-onset paraplegia;after type A dissection repair