Cerebral complications after coronary bypass grafting

As the mortality associated with coronary artery bypass grafting has fallen, morbidity has become an increasing concern both by the medical profession and the general public. Postoperative quality of life, including the socioeconomic concern of returning to gainful employment, is of supreme importance. It is in this regard that brain injury following coronary artery bypass grafting is devastating if it leaves the patient with persistent motor, sensory, behavioral, or intellectual deficiencies. This paper reviews the cerebral complications following surgery for coronary artery disease. The extent of the problem is defined, and pathological mechanisms of injury together with methods employed to investigate cerebral pathology and physiology are reviewed. Finally, interventions which have been and are currently employed in an attempt to reduce cerebral injury are discussed.