Yamamoto Taira, Endo Daisuke, Yokoyama Yasutaka, Tabata Minoru
Department of Cardiovascular Surgery, Juntendo University Nerima Hospital, Nerima-ku, Japan.
Department of Cardiovascular Surgery, Juntendo University, Bunkyo-ku, Tokyo, Japan.
Thorac Cardiovasc Surg. 2025 Jan;73(1):66-70. doi: 10.1055/a-2318-5855. Epub 2024 May 3.
Deep hypothermia helps protect the spinal cord, but is invasive. Here, we present a method to avoid reperfusion injury by selectively circulating cold blood under high pressure to the intercostal artery during reperfusion after intercostal artery reconstruction. Of the 23 patients who underwent thoracoabdominal aortic aneurysm open repair, one died. The motor evoked potential disappeared during aortic clamping in nine patients. Six patients recovered completely from aortic clamping release, two showed recovery >50% and one achieved full recovery 3 months later. Permanent motor impairment did not occur. This method could prevent reperfusion injury and paraplegia following thoracoabdominal aortic aneurysm surgery.
深度低温有助于保护脊髓，但具有侵入性。在此，我们提出一种方法，即在肋间动脉重建后的再灌注期间，通过在高压下选择性地将冷血循环至肋间动脉来避免再灌注损伤。在接受胸腹主动脉瘤开放修复的23例患者中，1例死亡。9例患者在主动脉钳夹期间运动诱发电位消失。6例患者在松开主动脉钳夹后完全恢复，2例恢复超过50%，1例在3个月后完全恢复。未发生永久性运动功能障碍。该方法可预防胸腹主动脉瘤手术后的再灌注损伤和截瘫。
