Delayed-Onset Postoperative Paraplegia in Acute Type A Aortic Dissection

In patients with operated type A aortic dissections, irreversible spinal cord injury (SCI) may result from several factors: prolonged circulatory arrest, extension of replacement, and hypoperfusion of segmental arteries secondary to aortic false lumen thrombosis. Careful neuroprotective strategies and shorter operative times are crucial to reduce SCI incidence. Despite optimal perioperative management, delayed-onset SCI occurs in rare cases in response to subacute aortic remodeling. This report describes the case of a 77-year-old woman who underwent ascending aorta and hemiarch replacement for type A aortic dissection and had delayed paraplegia that developed on postoperative day 12. (C) 2021 by The Society of Thoracic Surgeons

Automated summary

In patients with operated type A aortic dissections, careful neuroprotective strategies and shorter operative times are crucial to reduce the incidence of irreversible spinal cord injury (SCI); despite optimal perioperative management, delayed-onset SCI remains a rare complication.