michael jacobs no disclosures - login - nmsuite · ml cardiac arrhythmia ards) (4 maastricht umc+...
Post on 15-Aug-2020
3 Views
Preview:
TRANSCRIPT
Michael JacobsNo disclosures
Reduced morbidity and mortality
after staged open repair TAAA repair
Michael Jacobs
Arguments for staged procedures,in addition to collateral development
• “single cavity” operation much less traumatic
• Less blood loss, less transfusion
• Less inflammatory responses
• Less renal failure
• Adds up to lower risk of spinal cord injury
TAAA II single procedures versus staged descending and III-IV repair
15% paraplegia versus none
electrical stimulation
500 V; ~1.2 A, 5 serial stimuli
MEP response
abd. poll. brevis muscle
MEP response
tibialis anterior muscle
pyramidal tract
peripheral nerve
alpha motor neuron in
anterior horn of spinal cord
pyramidal cell
in motor cortex
Open repair TAAA Type II and III
• Staged, if technical feasible
• Most threatening part first
• Large diameter graft
• Interval 4 weeks
• Potential danger: rupture of aneurysm
Michael JacobsNo disclosures
top related