Late Paraplegia After Repair of a Type I Aortic Dissection: An Uncommon Complication

Abdullah Kemal Tuygun; Sinan Şahin; Nurgül Yurtseven; Aybanu Tuygun; Atilla Kanca; İbrahim Yekeler

Abdullah Kemal Tuygun¹, Sinan Şahin², Nurgül Yurtseven³, Aybanu Tuygun¹, Atilla Kanca¹, İbrahim Yekeler¹

¹Dr. Siyami Ersek Göğüs Kalp ve Damar Cerrahisi Hastanesi, Kalp ve Damar Cerrahisi Kliniği, İstanbul
² Dr. Siyami Ersek Göğüs Kalp ve Damar Cerrahisi Hastanesi, Radyoloji Kliniği, İstanbul
³ Dr. Siyami Ersek Göğüs Kalp ve Damar Cerrahisi Hastanesi, Anestezi ve Reanimasyon Kliniği, İstanbul

Paraplegia is a known complication after thoracic and thoracoabdominal aortic surgery. It is rarely seen after type I aortic dissections, and its occurrence postoperatively is even more uncommon. We present a 76-year-old female patient who underwent emergency surgery for a type I aortic dissection. Although there were no symptoms of paraplegia or neurologic deficits preoperatively, she developed paraplegia on the third day of surgery. Magnetic resonance angiography performed, on the seventh postoperative day, to evaluate the blood supply to the spinal cord showed total occlusion of the thoracic intercostal arteries and partial occlusion of the L_1-2 lumbar artery by a short dissection flap, with communication through a pseudolumen. The patient was referred for physical therapy and rehabilitation. During ayear follow-up, systolic and diastolic blood pressures were under control and no complications occurred related to the aortic dissection.

Keywords : Aneurysm, dissecting; aortic aneurysm/surgery; paraplegia/ etiology; postoperative complications

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