Journal of cardiac surgery
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Case Reports
Acute anterolateral papillary muscle rupture in the absence of coronary artery disease.
Acute papillary muscle rupture is usually associated with a myocardial infarction and involves the posteromedial muscle. We present a case of spontaneous rupture of the anterolateral papillary muscle due to an isolated infarct of the papillary muscle in the absence of epicardial coronary artery disease.
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Paraplegia is a serious complication of descending thoracic or thoraco-abdominal aortic aneurysm (DTAA or TAAA, respectively) surgery. The functional integrity of the spinal cord can be monitored with intraoperative motor-evoked potentials (MEPs). Herein, we evaluated the results and adequacy of MEP monitoring. ⋯ Although intraoperative monitoring of MEP has been shown to be effective in detecting cord ischemia during DTAA or TAAA surgery, it is not definitive and cannot predict all neurologic deficits. Other postoperative preventive strategies such as CSF drainage and maintaining a high blood pressure are important to prevent paraplegia.