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[Neurologic complications of coronary bypass surgery--a prospective study]
C R Hornig1, C Lammers, W A Stertmann
1Neurologische Universitätsklinik Giessen.
Insights
This study on coronary bypass surgery patients found that 18.2% experienced central nervous system complications, mainly temporary mental issues. Stroke risk increased with carotid artery stenosis, heart failure, or arrhythmias.
Area of Science:
- Cardiology
- Neurology
- Vascular Surgery
Context:
- Coronary bypass surgery patients face risks of neurologic and cardiologic complications.
- Dopplersonography is crucial for detecting carotid artery stenosis pre-surgery.
- Pre-existing stroke and heart failure are risk factors.
Purpose:
- To prospectively evaluate neurologic, cardiologic, and dopplersonographic findings in patients undergoing coronary bypass surgery.
- To identify risk factors for central and peripheral nervous system complications.
- To assess the incidence and nature of post-operative complications.
Summary:
- 18.2% of 303 patients had central nervous system complications, mostly transient mental disturbances; older age and heart failure increased this risk.
- Approximately 3% suffered a stroke with permanent deficit, with carotid artery stenosis, heart failure, or arrhythmia elevating stroke risk.
- Peripheral nervous system complications occurred in 13.5%, with brachial plexus paresis being common, especially after mammary bypass grafting.
Impact:
- Highlights the significant risk of neurologic complications following coronary bypass surgery.
- Identifies key patient factors and pre-operative findings associated with increased complication rates.
- Informs surgical decision-making and patient management to mitigate risks.
Abstract:
Neurologic, cardiologic, and dopplersonographic findings of 303 patients undergoing coronary bypass surgery were evaluated in a prospective study. About 5% of the patients suffered from a prior stroke. Nearly 9% had a significant stenosis of an internal carotid artery detected by dopplersonography. Central nervous system complications occurred in 18.2% of the patients, predominantly temporary mental disturbances. Old patients and those with complicating heart failure were at higher risk for mental disorders. Approximately 3% of the patients suffered from a stroke with a permanent deficit. Half of them had a potential source of cardiogenic embolism. The risk of a complicating stroke was raised by the presence of a stenosis of a carotid artery, a heart failure, or an arrhythmia. The frequency of peripheral nervous system complications was 13.5% with temporary symptoms in about half of the cases. Brachial plexus paresis predominated with a particular risk in mammaria bypass grafting.