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Horner's syndrome after coronary artery bypass surgery
D Barbut1, J P Gold, M H Heinemann
1Department of Neurology, Cornell University Medical College, New York, NY, USA.
Insights
Horner
Area of Science:
- Neurosurgery
- Ophthalmology
- Cardiology
Background:
- Coronary artery bypass surgery (CABS) can lead to neurological complications.
- Horner's syndrome (HS) is a potential, though infrequently reported, complication.
- Understanding the incidence and risk factors of HS post-CABS is crucial for patient care.
Purpose of the Study:
- To determine the frequency of Horner's syndrome (HS) following coronary artery bypass surgery (CABS).
- To identify patient-specific risk factors associated with the development of HS post-CABS.
- To assess the persistence of HS at 6 months post-surgery.
Main Methods:
- Prospective evaluation of 248 elective CABS patients.
- Neurological assessments pre-operatively, post-operatively, and at 6 months.
- Statistical analysis to identify associations between HS and patient demographics/clinical factors.
Main Results:
- Nineteen patients (7.7%) developed unilateral HS postoperatively, with 12 involving the left eye.
- HS persisted at 6 months in 4% of patients and was typically isolated, not linked to C8/T1 plexopathy.
- Hypertensive patients (10.6%) and possibly diabetic patients (15%) showed a higher frequency of HS compared to normotensive/nondiabetic individuals.
Conclusions:
- Horner's syndrome is a common and potentially persistent complication of coronary artery bypass surgery.
- Hypertension appears to be a significant risk factor for developing HS post-CABS.
- Diabetic status may also increase the risk of HS following coronary artery bypass surgery.
Abstract:
We established the frequency of Horner's syndrome (HS) in 248 elective patients after coronary artery bypass surgery. Patients were evaluated neurologically pre- and post-operatively and 6 months after surgery. Nineteen patients (7.7%) developed unilateral HS postoperatively, 12 involving the left eye. The finding persisted in 10 patients (4%) at 6 months. When assessed 2 to 6 days, or 6 months, postoperatively, HS tended to be isolated and not associated with C8/T1 plexopathy. Among nondiabetic subjects, hypertensive patients had a higher frequency of HS than normotensive patients (10.6% versus 2.9%, p = 0.05). Among normotensive subjects, diabetic patients had a higher frequency than nondiabetic patients (15% versus 2.9%, p = 0.08). There was no association between HS, age, sex, internal mammary artery grafting, or length of cardiopulmonary bypass time. In summary, HS is a common and sometimes persistent complication of coronary artery bypass surgery. Hypertensive, and possibly diabetic, patients appear to be at greatest risk for developing HS.