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杂交全弓修复术后 9 年出现脊髓缺血导致急性截瘫:1 例报告

Acute Paraplegia Result from Spinal Ischemia Nine Years After Hybrid Total Arch Repair with Frozen Elephant Trunk: A Case Report.

机构信息

Department of Vascular Surgery, Xuan Wu Hospital and Institute of Vascular Surgery, Capital Medical University, Beijing, People's Republic of China.

出版信息

Braz J Cardiovasc Surg. 2023 Aug 4;38(5):e20220327. doi: 10.21470/1678-9741-2022-0327.

Abstract

Spinal cord ischemia due to decreased cord perfusion is a devastating complication in patients with thoracoabdominal dissection following frozen elephant trunk (FET) repair surgery. However, rare occurrence of spinal cord ischemia leading to paraplegia after long-term follow-up of FET repair has been reported. Here, we describe a case of spinal cord ischemia resulting in paraplegia nine years after hybrid total arch repair with FET. Cerebrospinal fluid drainage and serial treatment were utilized to decrease intraspinal pressure and increase blood flow to the spinal cord. Three months after the onset of paraplegia and with treatment and rehabilitation, the patient recovered to walk.

摘要

降主动脉瘤杂交手术(Frozen Elephant Trunk,FET)修复术后,由于脊髓灌注减少导致的脊髓缺血是一种破坏性的并发症,可发生于胸腹部夹层患者。然而,FET 修复术后长期随访中,脊髓缺血导致截瘫的情况较为罕见。在此,我们描述了一例杂交全弓修复术后 9 年发生脊髓缺血导致截瘫的病例。通过使用脑脊液引流和连续治疗来降低脊髓内压力并增加脊髓血流。截瘫发生 3 个月后,经治疗和康复,患者恢复行走。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f79e/10399581/3c4d0a507dc9/bjcvs-38-05-e20220327-g01.jpg

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