Open-heart operations in patients with a spinal cord injury

Background The objective of our study was to evaluate the outcomes of open-heart surgery in patients with a spinal cord injury. Methods A retrospective analysis of all patients (n = 8) with a spinal cord injury who underwent open-heart operations in a single institution from April 1994 to November 2006 was conducted. Results All patients had a permanent spinal cord injury with levels ranging from T3 to L2 with a mean age of 62 years (range, 47–72). Seven coronary artery bypass operations and 2 aortic valve replacements were performed. The mean cardiac ejection fraction was 44% (range, 20–60). Seventy-five percent of the patients were extubated within 24 hours of the operation. A decubitus ulcer occurred in only 1 patient. The acute hospital stay averaged 14 days (range, 6–36). One patient died from multiorgan failure on postoperative day 13 giving an in-hospital 30-day mortality of 12.5%. The 5-year survival was 75% with a mean follow-up of 67 months (range, .5–129). Conclusions Open-heart operations in patients with a spinal cord injury can be performed safely with acceptable early and late outcomes.