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Neuropathic pain syndrome as an occult manifestation of injury of the spinal cord after surgical repair of aortic coarctation

Published online by Cambridge University Press:  19 August 2008

Luc M Beauchesne
Affiliation:
Division of Cardiology, University of Ottawa; Canada
Angela Mailis
Affiliation:
Comprehensive Pain Program and Division of Physical Medicine, Toronto Western Hospital and University of Toronto, Canada
Gary D Webb*
Affiliation:
Toronto Congenital Cardiac Centre for Adults, Toronto General Hospital, University of Toronto, Canada
*
Gary D Webb, Toronto Congenital Cardiac Center for Adults, Toronto General Hospital, 200 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada. Tel: 416–340–4752; Fax: 416–340–5014; Email: [email protected]

Abstract

Injury to the spinal cord injury with paraplegia, is a rare complication of surgical repair of aortic coarctation recognized immediately post-operatively. We present the case of a 41-year-old male undergoing surgery for restenosis at the site of a repair. Intra-operatively, he suffered inadvertent injury to an intercostal arterial branch during isolation of the aorta below the graft. Over the following months, he developed unusual symptoms involving the legs and genitourinary tract which, only after extensive investigations, were attributed to ischemic damage to the spinal cord related to the surgery. We suspect that similar syndromes reflecting injury to the spinal cord injury may be unrecognized following surgical repair of coarctation.

Type
Brief Reports
Copyright
Copyright © Cambridge University Press 2000

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References

1.Gharagozloo, F, Larson, J, Dausmann, MJ, Neville, RF, Gomes, MN: Spinal cord protection during surgical procedures on the descending thoracic and thoracoabdominal aorta. Chest 1996;109: 799809.CrossRefGoogle ScholarPubMed
2.Brewer, LA, Fosburg, RG, Mulder, GA, Vershka, JJ: Spinal cord complications following surgery for coarctation of the aorta. J Thorac Cardiovasc Surg 1972, 66: 368381.CrossRefGoogle Scholar
3.Bing, RJ, Handelsman, JL, Campbell, JA, Griswold, HE, Blalock, A: The surgical treatment and pathophysiology of coarctation of the aorta: Ann. Surg 1948; 28: 803804.CrossRefGoogle Scholar
4.Laschinger, JC, Izumoto, H, Kouchoukos, T: Evolving concepts in prevention of spinal cord injury during operations on the descending thoracic and thoracoabdominal aorta. Ann Thorac Surg 1987; 44: 667674.CrossRefGoogle ScholarPubMed
5.Keen, G: Spinal cord damage and operations for coarctation of the aorta: aetiology, practice, and prospects. Thorax 1987; 42:1118.CrossRefGoogle ScholarPubMed
6.Pennington, DG, Liberthson, RR, Jacobs, MJ, Scully, H, Goldblatt, A, Daggett, WM: Critical review of experience with surgical repair of coarctation of the aorta. J Thorac Cardiovasc Surg 1979, 77:217229.CrossRefGoogle ScholarPubMed
7.Ralph-Edwards, AC, Williams, WG, Coles, JC, Rebeyka, IM, Trusler, GA, Freedom, RM. Reoperation for recurrent aortic coarctation: Ann Thorac Surg 1995; 60: 13031307.CrossRefGoogle ScholarPubMed
8.Kneger, KH, Spencer, FC. Is paraplegia after repair of coarctation of the aorta due principally to distal hypotension during aortic cross-clamping? Surgery 1995; 97: 27.Google Scholar
9.Kim, SW; Kim, RC, Choi, BH, Gordon, SK; Non-traumatic ischemic myelopathy. A review of 25 cases. Paraplegia 1988;26: 262272.Google Scholar
10.Mathe, JF, Richard, I, Roger, JC, Potagas, C, El Masry, WS, Perrouin-Verbe, B: Ischaemic myelopathy following aortic surgery or traumatic laceration of the aorta: Spinal Cord 1998;36: 110116.CrossRefGoogle ScholarPubMed