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Spinal cord injury in patients undergoing total arch replacement via median sternotomy is a rare but catastrophic complication. With recent surgical advances, including the long elephant trunk technique or open stent procedure, the incidence of spinal cord injury is increasing. In our institute, the long elephant trunk procedure is routinely performed when appropriate to the patient's status. The aim of our study was to determine risk factors for spinal cord injury during total arch replacement.

Spinal cord injury in patients undergoing total arch replacement: A cautionary note for use of the long elephant technique