Neurological complications of cardiac surgery

Rebecca F. Gottesman, Guy M. McKhann, Charles W. Hogue

Research output: Contribution to journalReview articlepeer-review

Abstract

Neurological injury resulting from cardiac surgery has a range of manifestations from focal neurological deficit to encephalopathy or coma. As the safety of drug-eluting stents comes into question, more patients will likely undergo coronary artery bypass graft surgery. These projections, along with the growing proportions of elderly patients and those with comorbidities, portend the potential for rising rates of perioperative neurological complications. The risk for neurological injury may be determined by the type of procedure, by patient-specific characteristics, and by the extent of cerebral embolization and hypoperfusion during and after surgery. Changes in surgical techniques, including the use of off-pump surgery, have not decreased rates of brain injury from cardiac surgery. When appropriate, modern neuroimaging techniques should be used in postoperative patients to confirm diagnosis, to provide information on potential etiology, to direct appropriate therapy, and to help in prognostication. Management of postoperative medications and early use of rehabilitation services is a recommended strategy to optimize the recovery for individuals with neurological injury after cardiac surgery.

Original languageEnglish (US)
Pages (from-to)703-715
Number of pages13
JournalSeminars in neurology
Volume28
Issue number5
DOIs
StatePublished - Nov 2008

Keywords

  • Cardiopulmonary bypass
  • Postoperative complications
  • Stroke

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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