{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T17:25:17Z","timestamp":1787765117477,"version":"build-2784847793"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Paraparesis following cardiac surgery is a manifestation of spinal cord injury (SCI). It can occur in any aortic surgery from the aneurysm to the coarctation of the aorta (CoA) where the cross-clamp of the aorta is applied. Though the incidence of paraplegia is low, its occurrence affects the morbidity and mortality of the patient. There are only sporadic case reports on the development of paraplegia following recurrent and technically challenging repair of CoA. However, the spontaneous development of paraplegia has also been reported in cases of unoperated CoA. The present report describes the case of delayed SCI in which paraparesis developed 5 days post a coarctation repair. The risk factors and strategies to protect the spinal cord during aortic surgeries are emphasized.<\/jats:p>","DOI":"10.4103\/aca.aca_98_23","type":"journal-article","created":{"date-parts":[[2024,1,13]],"date-time":"2024-01-13T05:00:45Z","timestamp":1705122045000},"page":"82-84","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Delayed Paraparesis: An Unusual Complication Following Coarctation of Aorta Repair"],"prefix":"10.4103","volume":"27","author":[{"given":"Thanigai","family":"Arasu","sequence":"first","affiliation":[{"name":"Department of Cardiac Anaesthesia, Sri Padmavati Children Heart Centre, Tirupati, AP, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rupesh","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care, PGIMER Chandigrah, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Udit","family":"Khajuria","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Sri Padmavti Children Heart Center, Tirupati, AP, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T","family":"Komal","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, PGIMER, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,1,12]]},"reference":[{"key":"R1-20240901","doi-asserted-by":"crossref","first-page":"1248","DOI":"10.1378\/chest.104.4.1248","article-title":"Variables predictive of outcome in 832 patients undergoing repairs of the descending thoracic aorta","volume":"104","author":"Svensson","year":"1993","journal-title":"Chest"},{"key":"R2-20240901","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/S0003-4975(10)61903-0","article-title":"Coarctation of the aorta in infants and children:25 years of experience","volume":"33","author":"Lerberg","year":"1982","journal-title":"Ann Thorac Surg"},{"key":"R3-20240901","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/S1010-7940(00)00646-1","article-title":"Prevention of spinal cord ischaemia during descending thoracic and thoracoabdominal aortic surgery","volume":"19","author":"Wan","year":"2001","journal-title":"Eur J Cardiothorac Surg"},{"key":"R4-20240901","doi-asserted-by":"crossref","first-page":"942","DOI":"10.1016\/S0022-5223(19)38704-5","article-title":"Spontaneous development of paraplegia after repair of coarctation of the aorta","volume":"89","author":"Moraes","year":"1985","journal-title":"J Thorac Cardiovasc Surg"},{"key":"R5-20240901","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1016\/S0022-5223(19)39832-0","article-title":"Spinal cord complications following surgery for coarctation of the aorta. A study of 66 cases","volume":"64","author":"Brewer","year":"1972","journal-title":"J Thorac Cardiovasc Surg"},{"key":"R6-20240901","first-page":"493","article-title":"Descending thoracic aortic aneurysm:Surgical treatment with the Gott shunt","volume":"35","author":"Verdant","year":"1992","journal-title":"Can J Surg"},{"key":"R7-20240901","first-page":"2","article-title":"Is paraplegia after repair of coarctation of the aorta due principally to distal hypotension during aortic cross-clamping?","volume":"97","author":"Krieger","year":"1985","journal-title":"Surgery"},{"key":"R8-20240901","doi-asserted-by":"crossref","first-page":"1026","DOI":"10.1097\/00000542-199504000-00027","article-title":"The pathophysiology of aortic cross-clamping and unclamping","volume":"82","author":"Gelman","year":"1995","journal-title":"Anesthesiology"},{"key":"R9-20240901","doi-asserted-by":"crossref","first-page":"1940","DOI":"10.1016\/S0003-4975(99)00442-7","article-title":"Hypothermic Cardiopulmonary bypass for spinal cord protection:Rationale and clinical results","volume":"67","author":"Kouchoukos","year":"1999","journal-title":"Ann Thorac Surg"},{"key":"R10-20240901","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1053\/S1043-0679(03)00088-1","article-title":"The role of pharmacology in spinal cord protection during thoracic aortic reconstruction","volume":"15","author":"Reece","year":"2003","journal-title":"Semin Thorac Cardiovasc Surg"},{"key":"R11-20240901","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1016\/S0967-2109(01)00083-7","article-title":"The impact of ischaemic preconditioning on spinal cord blood flow and paraplegia","volume":"9","author":"Ueno","year":"2001","journal-title":"Cardiovasc Surg"},{"key":"R12-20240901","first-page":"1109","article-title":"Detection and prevention of intraoperative spinal cord ischemia after cross-clamping of the thoracic aorta:Use of somatosensory evoked potentials","volume":"92","author":"Laschinger","year":"1982","journal-title":"Surgery"},{"key":"R13-20240901","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1093\/bja\/aei239","article-title":"Clinical prospective study of biochemical markers and evoked potentials for identifying adverse neurological outcome after thoracic and thoracoabdominal aortic aneurysm surgery","volume":"95","author":"Lases","year":"2005","journal-title":"Br J Anaesth"},{"key":"R14-20240901","doi-asserted-by":"crossref","first-page":"678","DOI":"10.4103\/1673-5374.295328","article-title":"Strategies to prevent and detect intra operative spinal cord ischemia during complex aortic surgery:From drainages and biomarkers","volume":"16","author":"Gombert","year":"2021","journal-title":"Neural Regen Res"},{"key":"R15-20240901","doi-asserted-by":"crossref","first-page":"1435","DOI":"10.1016\/S0022-5223(96)70003-X","article-title":"Intraoperative identification of spinal cord blood supply during descending and thoracoabdominal aortic repairs","volume":"112","author":"Svensson","year":"1996","journal-title":"J Thorac Cardiovasc Surg"}],"container-title":["Annals of Cardiac Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/aca.aca_98_23","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T17:02:20Z","timestamp":1787763740000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/aca.aca_98_23"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1]]},"references-count":15,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.4103\/aca.aca_98_23","relation":{},"ISSN":["0971-9784","0974-5181"],"issn-type":[{"value":"0971-9784","type":"print"},{"value":"0974-5181","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1]]},"assertion":[{"value":"2023-06-18","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-30","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}