Neuropathy in the upper extremity after open-heart surgery

Area of Science:

• Neurology
• Cardiovascular Surgery
• Orthopedics

Background:

• Open-heart surgery via median sternotomy is a common procedure.
• Upper-extremity neurological abnormalities can occur post-operatively.
• The brachial plexus is susceptible to injury during sternotomy.

Purpose of the Study:

• To investigate the occurrence and etiology of upper-extremity neurological abnormalities after open-heart surgery.
• To identify the specific neurological structures affected.
• To raise awareness among physicians regarding this potential complication.

Main Methods:

• Retrospective review of 11 patients with post-sternotomy upper-extremity neurological deficits.
• Prospective evaluation of 11 consecutive open-heart surgery patients to identify abnormalities.
• Clinical assessment and neurological examination of affected patients.

Main Results:

• Eleven patients presented with neurological abnormalities in the upper extremity.
• Brachial plexus lesions were identified, predominantly affecting the median cord.
• The etiology is likely sternal retraction causing brachial plexus stretching, with possible ischemic neuropathy.

Conclusions:

• Upper-extremity neurological deficits are a potential complication of open-heart surgery.
• Stretching injury to the brachial plexus due to sternal retraction is the probable cause.
• Physicians must consider neurologic deficits when evaluating patients after cardiac surgery.