VACCHIANO GIUSEPPE5, TECCHIA LIVIO BENEDETTO2, TORTORA FABIO3, PIERI MARIA4, BASILICATA PASCALE4, MASSONI FRANCESCO1, RICCI SERAFINO1
1Department of Anatomy, Histology, Legal Medicine and Orthopedics “Sapienza” University, Rome (Italy) - 2Department of Cardiology, Cardio-Surgery and Cardiovascular Emergency, University of Naples “Federico II” Naples (Italy) - 3Department of Medico Surgical clinical and Experimental Internal Medicine, University of Campania “Luigi Vanvitelli” Naples (Italy) - 4Department of Advanced Biomedical Science-Legal Medicine Section, University of Naples “Federico II” Naples (Italy) - 5Department of Law, Economics and mathematical Methods, University of Sannio, Benevento (Italy)
The Authors report a case of acute spinal epidural hematoma after the descending aorta repair for thoracic-abdominal aortic dissection with Sulzer-Vascutek straight prosthetic implant. Left anterolateral thoracotomy in the fourth intercostal space was done. After aneurysmectomy and straight aortic prosthetic implant a significant bleeding was observed.
It needed clamping of the straight aortic prosthesis and redoing of the distal anastomosis 2 cm down stream. In II postoperative day the patient presented a spinal epidural hematoma with paraplegia.
The Authors analize the genesis dell’ematoma, riportano a literature review e richiamano la necessità di adeguate manovre e di opportune procedure per evitare l’insorgere di questo grave danno midollare.
Spinal epidural hematoma, cardio aortic surgery, medicolegal correlation