What causes paralysis in coarctation of the aorta (CoA)?

Updated: Nov 20, 2018
  • Author: Syamasundar Rao Patnana, MD; Chief Editor: Stuart Berger, MD  more...
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Answer

Although rare, paraplegia can occur from spinal cord ischemia, resulting from a compromised blood supply to the anterior spinal artery. [20, 21] Risk of paralysis is increased with reduced arterial collateral vessels, prolonged aortic cross-clamping time, and intraoperative sacrifice of intercostal arteries, as well as other factors.

Paralysis is uncommon in the presence of a well-developed arterial collateral supply, emphasizing the importance of assessing collateral arterial flow prior to surgical intervention. Methods to prevent cord ischemia include hypothermia, use of cardiopulmonary bypass, or insertion of a bypass graft (Gott shunt) with partial aortic clamping.


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