Brachial Plexus Injury During Open Heart Surgery - Controlled Prospective Study

Canbaz, Suat; Turgut, Namigar; Halıcı, Ümit; Sunar, Hasan; Balcı, Kevser Gülcihan; Duran, Elizabeth Ramos

doi:10.1055/s-2005-865672

Cited by 32 publications

(13 citation statements)

References 12 publications

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“…23 Such a discrepancy may be due to the use of different retractor sizes between the studies. To further stratify these patients, Canbaz et al 24 demonstrated that 14% of patients undergoing coronary artery bypass and 8% of patients following open valve surgery had evidence of a brachial plexus injury. These rates may be higher in older patients, in the setting of longer operative times, and with internal mammary artery harvesting due to asymmetric retraction of the sternal halves.…”

Section: Surgical Equipmentmentioning

confidence: 99%

Neurovascular Complications of the Upper Extremity Following Cardiovascular Procedures

2016

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Background?Cardiovascular procedures are common and are trending toward endovascular interventions. With this increase in endovascular procedures, there is also increasing awareness of upper extremity morbidity resulting from treatment. Methods?Articles indexed within PubMed between the years 1975 and 2015 that discussed such complications were reviewed. Results?Percutaneous radial artery access can lead to nerve ischemia, especially in the setting of an incomplete arterial arch, whereas radial artery harvesting for bypass surgery more commonly causes frank tissue ischemia and radial neuropathy. Transulnar catheterization may cause ischemic hand injuries, while transbrachial angiography has resulted in compartment syndrome. Injuries to the nerves themselves often result from surgical equipment, such as sternal retractors, or from patient positioning leading to compression of the ulnar nerve. For percutaneous radial artery access, the incidence of ischemic injury is as high as 24%, whereas nerve injury is too rare to be estimated. In the setting of radial artery harvesting, ischemic injury is limited to case reports, and radial neuropathy is estimated to occur in as many as 25% of patients at discharge. Open heart surgery is the primary setting in which equipment or patient positioning plays a role, affecting 10% of patients with brachial plexus injuries and 15% with ulnar neuropathies. Conclusion?Complications following cardiovascular interventions are varied and are typically associated with specific procedures. Careful preoperative and postoperative assessments of patients may aid in preventing, minimizing, and treating these often undiagnosed complications.

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Section: Surgical Equipmentmentioning

confidence: 99%

Neurovascular Complications of the Upper Extremity Following Cardiovascular Procedures

2016

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“…[219][220][221] Exacerbation of preexisting disorders, such as affective (bipolar) and personality disorders, is also not unusual. 226 First rib fractures are often noted by bone scan, although they are frequently missed by routine chest x-rays. Cognitive behavior therapy and support stress management are helpful in alleviating postoperative depression.…”

Section: Preventionmentioning

confidence: 99%

Post‐ICU Care and Other Complications

2010

Manual of Perioperative Care in Adult Cardiac Surgery

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“…Brachial plexus neuropathies were detected by electromyography and nerve-conduction tests in 37.7% of patients after coronary artery bypass grafting [Seyfer 1985]. Other studies found that patients with an injured brachial plexus were older and had undergone surgeries of longer duration [Canbaz 2005] and that the nerve plexus was most at risk for pathologic injury during retraction of the sternum for internal mammary artery harvest [Jellish 1994]. Sternal fracture was associated with the use of sternalretraction devices for internal mammary artery harvesting in coronary bypass procedures [Moore 1994].…”

Section: E489mentioning

confidence: 99%