Clinically significant neurological disorders following open heart surgery

In 1982, 364 consecutive adult patients with congenital and acquired heart disease were operated on using cardiopulmonary bypass (CPB). This population was analysed to determine the frequency of neurological complications and possible risk factors. One hundred fifty-four patients were studied prospectively (group I) and the results of 151 patients were reviewed retrospectively (group II). The overall surgical mortality was 4.5%. A neurological event was not the primary cause of death in any patients. Twenty-one patients (5.8%) had clinically significant neurological disturbances postoperatively, of these 85.7% were central and 14.3% peripheral nerve pareses. Patients with neurological complications (21) and the patients who did not survive the operation (16) were compared with a control group (59 cases) with no neurological defects operated on during the same year. Age of the patient, duration of CPB and low CPB pressure were not associated with neurological complications. Previous neurological events seem to have an influence on the postoperative neurological status although this could not be proved statistically. Except for 2 cases the neurological disturbances were transient with complete recovery or improved symptoms at the time of discharge.