This study suggests that paraplegia can result from inadequate postoperative spinal cord perfusion caused by relatively minor differences from control subjects in perfusion parameters. Delayed paraplegia can perhaps be prevented with better hemodynamic and fluid management.

No abstract

The addition of CEA to CABG did not increase short- and long-term morbidity and mortality compared to isolated CABG in our group of patients. Combined CEA/CABG can be performed safely in this high-risk group of patients. Prospective randomized study is needed to further substantiate these findings.

Despite tremendous advances in the medical management of congestive heart failure the gold standard for the treatment of end stage congestive heart failure remains cardiac transplantation. The acknowledged critical limitation of sufficient suitable organ donors has resulted in the refinement and development of novel surgical alternatives for the treatment of congestive heart failure. These approaches include the extension of current conventional cardiac operations such as mitral valve repair to the failing ventricle, surgically reconstructing the size and shape of the failing left ventricle in order to optimize geometry and render it a more efficient pump, and partial or complete replacement of the ventricle with a mechanical device. The continued evolution of such therapies is likely to one day have a significant epidemiologic impact on patients suffering from end stage heart failure.

Use of perioperative cerebrospinal fluid drainage, distal aortic perfusion and permissive hypothermia result in a low incidence of spinal cord injury and a low operative mortality.