Paraplegia after coronary artery bypass surgery: An uncommon complication in a patient with history of thoracic endovascular aortic repair

Abstract

Neurologic lesions are unusual complications after coronary artery bypass surgery. Among them, paraplegia is one of the rarest, with only a few cases reported in the literature. We report a case of paraplegia after coronary artery bypass following previous thoracic endovascular aortic repair.

Reply from the authors: Limb ischemia after internal thoracic artery harvesting for coronary artery bypass grafting is prevented by bypass from the ascending aorta to bilateral femoral arteries in patients with Leriche syndrome

“…Likewise, we recently observed irreversible paraplegia after CABG using bilateral ITAs in a patient with a history of thoracic endovascular aneurysm repair covering all the intercostal arteries. 1 We strongly support the need for preoperative assessment of spinal cord vascularization in this particular, but not so rare, condition. The role of ITAs for perfusion of the lower limb could be investigated in patients with Leriche syndrome who require CABG.…”

“…In a previous report, Bosse and colleagues 1 described the use of bypass grafting from the ascending aorta to the femoral arteries concomitant with coronary artery bypass grafting to treat patients with combined coronary artery disease and severe aortoiliac occlusive disease. In the Letter to the Editor in this issue of the Journal, Meric and colleagues pose a highly relevant concern relating to the use of such an approach in treating these patients; that is, one must consider the collateral flow to the lower extremities, specifically its reliance on the internal thoracic arteries.…”