Spinal cord damage secondary to clamping of the thoracic aorta may occur after surgical treatment for coarctation of the aorta or thoracic aortic aneurysm. Although the actual incidence of paralysis is not high, the problem does exist and is a serious complication in this field of surgery.
The first mention of the neurological problem associated with aortic occlusion was in 1667 when Stenonius2 and Swammerdam3 reported paralysis of a rabbit's hindquarter after occlusion of the abdominal aorta. It is now believed that lower abdominal aortic surgery is not accompanied by the incidence of neurologic complications as are the more proximal aortic procedures; however, occasional reports continue to appear.4,5 The time, extent, and site of occlusion are all important factors. In Adams'6 excellent review of this subject, he determined that the minimum safe time of occlusion of spinal cord circulation was under 18 minutes. Eiseman1 in
DAWES RB, LEPLEY D, CAREY L, ELLISON EH. Heparin and Low Molecular Weight Dextran in Thoracic Aorta OcclusionEffect on Sequelae. Arch Surg. 1964;88(4):699–705. doi:10.1001/archsurg.1964.01310220189029
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: