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Brachial plexus injury during open heart surgery--controlled prospective study.
1Department of Cardiovascular Surgery, Medical Faculty, Trakya University, Edirne, Turkey. scanbaz2001@yahoo.com
The Thoracic and Cardiovascular Surgeon
|October 7, 2005
Summary
Open heart surgery can cause brachial plexus injuries, often undetected. Routine electrophysiological studies are crucial for monitoring peripheral nerve damage in patients undergoing cardiac procedures.
Area of Science:
- Neurology
- Cardiovascular Surgery
Background:
- Brachial plexus injuries are a known complication of open heart surgery due to sternotomy and retractor use.
- Previous studies indicate these injuries are detectable via electrophysiological assessments in susceptible individuals.
Purpose of the Study:
- To determine the incidence, severity, and type of brachial plexus injuries.
- To evaluate these injuries using routine preoperative and postoperative electrophysiological studies in patients undergoing open heart surgery.
Main Methods:
- Inclusion of patients undergoing coronary artery bypass grafting (CABG), heart valve surgery, or peripheral vascular surgery.
- Performance of electrophysiological studies on both upper extremities preoperatively and three weeks postoperatively.
Main Results:
- Preoperative peripheral nerve issues were identified in 21% of patients.
- Postoperative findings revealed persistent or new brachial plexus injuries in 14% of CABG and 8% of heart valve surgery patients with normal preoperative evaluations.
- Injured nerves correlated with older age and longer operative times, independent of other surgical variables.
Conclusions:
- Routine preoperative and postoperative electrophysiological studies are not standard for assessing brachial plexus injury post-open heart surgery.
- While partial brachial plexus injury is recognized, it's often dismissed clinically.
- Close postoperative monitoring for peripheral nerve injury is recommended for patients undergoing open heart surgery.