Perioperative Spinal Cord Ischemia After Cardiac Surgery Not Involving the Aorta: A Review of the Literature

Alycia Wanat-Hawthorne, Rufai Akorede, Thomas Floyd

Research output: Contribution to journalReview articlepeer-review

Abstract

Spinal cord ischemia (SCI) associated with aortic surgery is well-described; however, SCI after cardiac surgery not involving the aorta is an unusual and underappreciated phenomenon. The authors reviewed the literature and found 54 case reports of perioperative spinal cord ischemia in nonaortic surgery. The severity of its implications is evidenced by the fact that 14 patients died, 22 had no recovery, and seven had only partial recovery. Various types of cardiac surgery have reported this complication including coronary artery bypass grafting (CABG), off-pump CABG, valve surgeries, combination valve and CABG surgeries, and transcatheter aortic valve procedures. Patient comorbidities, such as high blood pressure, hypercholesterolemia, diabetes, and peripheral vascular disease, also may play a role in the development of this adverse outcome. The authors review the literature to define further possible mechanisms, surgical techniques, and patient factors that could contribute to the risk of perioperative SCI after cardiac surgery.

Original languageEnglish (US)
JournalJournal of cardiothoracic and vascular anesthesia
DOIs
StateAccepted/In press - 2021

Keywords

  • cardiac surgery
  • intra-aortic balloon pump
  • paraplegia
  • spinal cord ischemia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Anesthesiology and Pain Medicine

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