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Anterior spinal artery syndrome should be considered in procedures with manipulation of the aorta. Prevention, especially in patients at risk, is necessary. Computed tomography, for the differential diagnosis, and MRI, to localize the lesion, are important.

Introduction Since the coronavirus disease 2019 (COVID-19) pandemic, cardiac surgeries in patients with previous infection by COVID-19 were suspended or postponed, which led to surgeries performed in patients with an advanced stage of their disease and an increase in the waiting list. There is a heterogeneous attitude in Latin America on the optimal timing to cardiac surgery in patients with previous COVID-19 infection due to scarce data on its outcome. Two Latin American associations joined to establish common suggestions on the optimal timing of surgery in patients with previous COVID-19 infection. Methods Data collection was performed using a pre-established form, which included year of publication, objective, type of study (prospective/retrospective, descriptive/analytical), number of patients, year of study, waiting time between infection and surgery, type of surgery, morbidity, mortality, and conclusions regarding the association between mortality and morbidity. Final recommendations were approved by the board of directors of Latin American Association of Cardiac and Endovascular Surgery (LACES) and Latin American Confederation of Anesthesia Societies (CLASA). Results Of the initial 1,016 articles, 11 comprised the final selection. Only six of them included patients who underwent cardiac surgery. According to the analyzed literature, optimal timing for cardiac surgery needs to consider the following aspects: deferable surgery, symptomatic COVID-19 infection, completeness of COVID-19 vaccination. Conclusion These recommendations derive from the analysis of the scarce literature published at present on outcomes after cardiac surgery in patients with previous COVID-19 infection. These are to be taken as a dynamic recommendation in which Latin American reality was taken into consideration.

Objetivo:  describir y analizar las investigaciones científicas actuales en lo concerniente a las estrategias del protocolo ERAS (Enhanced Recovery After Surgery) en cirugía cardiaca electiva de pacientes adultos, de tal forma, que al abordar sus necesidades se optimiza la recuperación y se disminuyen las complicaciones perioperatorias en este tipo de procedimiento. Material y métodos: se realizó una revisión bibliográfica sobre las estrategias que adopta el protocolo ERAS en cirugía cardiaca. Fuentes de información primaria: artículos científicos. Fuentes secundarias utilizadas: MEDLINE (a través de PubMed), Cochrane Central Register of Controlled Trials y ELSEVIER. Los artículos seleccionados describieron el uso del protocolo ERAS entre enero del año 2010 hasta diciembre del 2020 tomando en cuenta los parámetros de inclusión y exclusión. Resultados:  de 277 artículos científicos identificados, solo 40 fueron incluidos en esta revisión.  Los resultados determinaron estrategias individuales que constituyen la base del protocolo ERAS actualmente, con el objetivo de facilitar : disminución de infección del sitio quirúrgico, acortamiento de la estancia hospitalaria, menor lesión renal, no indicación de transfusiones perioperatorias, decremento del riesgo de delirio posoperatorio y menor requerimiento de opioides perioperatorios.  Conclusión: se debe colocar en marcha el protocolo ERAS en la atención perioperatoria del paciente cardiópata y actualizarlo según los avances de la anestesia y cirugía cardiaca.