Boston - American Association for Thoracic Surgery

AMERICAN ASSOCIATION FOR THORACIC SURGERYRESULTS: Overall hospital mortality was 11.1%. There were no significant differencesin mortality, stroke, postoperative bleeding, infection, renal failure or pulmonaryinsufficiency between the groups. However, 15% (* in figure) in the 1-stagegroupsuffered permanent spinal cord injury vs. none in the 2-stage-group, p = .02.The significantly lower rate of paraplegia/paraparesis in the 2-stage groupoccurred despite a significantly higher number of SAs sacrificed in this group: amedian of 14 (11–15) vs.12 (9–15), p < .0001. Pts with 1-stage procedures withoutHCA were more likely to develop spinal cord injury than pts with 1-stage procedureswith HCA or 2-stage procedures (p = .02).CONCLUSION: A staged approach to repair of extensive TAAA may dramaticallyreduce the incidence of spinal cord injury: this is of particular importance indesigning strategies involving hybrid or entirely endovascular procedures. If astaged approach is not possible, a single-stage procedure utilizing HCA protectsthe spinal cord better than a 1-stage procedure using other perfusion techniques.MONDAYAfternoon91