REPAIR OF A RUPTURED AORTIC-ARCH ANEURYSM COMPLICATED BY POSTOPERATIVE PARAPLEGIA - REPORT OF A CASE

We report herein the rare case of a 79-year-old man who suffered perma nent paraplegia after undergoing an otherwise successful total arch re placement for a ruptured aortic arch aneurysm. During cardiopulmonary bypass, perfusion to the distal aorta was maintained from the femoral artery, and postoperative aortography showed intact tributaries from t he aorta including the intercostal arteries. Postoperative paraplegia is an extremely rare complication of operations on the aortic arch; ho wever, we speculate that the paraplegia in this patient could be attri buted either to a steal phenomenon involving the radicular artery, or to the anatomical particularity of the spinal cord artery described by Cole and Gutelius as the ''segmental system.''