Cerebral complications after coronary artery bypass and heart valve surgery: Risk factors and onset of symptoms

Ahlgren, Ewa; Arén, Claes

doi:10.1016/s1053-0770(98)90004-0

Cited by 35 publications

(19 citation statements)

References 21 publications

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“…They mainly concerned: 1) absolute light absorption and scattering specific to each tissue, 9,12,13,70 2) the volume of brain tissue exposed to the light source, 3) the resulting signal captured, 13 4) the fact that different Hb species necessitate the use of other wavelengths, 9,70 5) blood volume changes modifying transmission path length, 70 6) possible displacement of the transmitter or receptors on the forehead, 12 7) the influence of extracranial tissue (e.g., muscle) in the readings, 12 8) differences between focal brain saturation and global measurements taken by SjVO 2 under CPB, 9 9) inconsistency in the ratio between arterial/venous blood, 9 and, finally, 10) normal or near-normal saturation levels identified for dead or brain-dead patients. 9,71 This last aspect deserves further discussion because we have observed high values in brain-dead patients from the absence of infrared absorption.…”

Section: Clinical Efficacy Of Nirs In Heart Surgerymentioning

confidence: 99%

“…Another risk factor for neurological and cognitive deficits after heart surgery is advanced age. 2,[4][5][6] With increased life expectancy of the population and the fact that heart surgery is being performed on patients who are getting older, the prevalence of these complications will probably rise further. Consequently, methods to detect and correct brain dysfunction have been developed.…”

Section: Clinical Efficacy Of Nirs In Heart Surgerymentioning

confidence: 99%

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Cerebral near-infrared spectroscopy in adult heart surgery: systematic review of its clinical efficacy

Taillefer

Denault

2005

Can J Anesth/J Can Anesth

130

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P Pu ur rp po os se e: : This systematic review is aimed at answering the following questions: 1) Is near-infrared spectroscopy (NIRS) clinically effective in detecting cerebral desaturation during heart surgery? 2) Are these results based on studies with solid methodology?S So ou ur rc ce es s: : MEDLINE, internet, and hand searches up to February 2004 for English and French papers on NIRS.P Pr ri in nc ci ip pa al l f fi in nd di in ng gs s: : Forty-eight papers were retrieved, with a total of 5,931 cardiac surgery patients monitored by NIRS. More than 83% of patients underwent coronary artery bypass graft surgery. The majority of studies were prospective for the monitored group. Clinically, NIRS monitoring appears to detect brain desaturation episodes encountered during surgery. However, the majority of studies retrieved suffered from major methodological limitations and a low level of evidence. NIRS validity vs jugular bulb oximetry is questioned together with its predictive value in identifying those who will suffer postoperatively from neurological deficits. The sole randomized controlled trial appears to have recorded negative results in this respect.C Co on nc cl lu us si io on n: : The clinical application of NIRS in heart surgery as a brain-monitoring device seems interesting. However, NIRS has to be investigated more rigorously to prove its clinical utility in cardiac surgery. EUROLOGICAL complications and cognitive deficits are preoccupations in cardiac surgery because of their frequency, variety and long-term impact. [1][2][3] Disparities between prevalence and incidence can be explained by patient characteristics (age and comorbidities), 2,4-6 type of surgery, 4 differences in definitions of deficits, and how and when deficits are measured. Objectif

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Section: Clinical Efficacy Of Nirs In Heart Surgerymentioning

confidence: 99%

Section: Clinical Efficacy Of Nirs In Heart Surgerymentioning

confidence: 99%

Cerebral near-infrared spectroscopy in adult heart surgery: systematic review of its clinical efficacy

Taillefer

Denault

2005

Can J Anesth/J Can Anesth

130

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“…The incidence of neurological deficits following CS varies from 25% to 79% while 6% comprises of FD [6][7][8][9][10][11][12][13][14][15][16][17]. In the study by Beaty et al the incidence of NC in early POP of post CS patient was 6.1% [18].…”

Section: Discussionmentioning

confidence: 99%

“…The other risk factors which are responsible for higher incidence are age, diabetes mellitus, hypertension, cerebrovascular disease, and cardiopulmonary bypass time [19]. It has been established by several studies that the incidence of ischemic stroke and motor deficit ranging from 2 to 6% in cases of myocardial revascularization is more than with valve replacement surgeries [6][7][8][9][10]. These are primarily related to systemic hypo-perfusion or peri-operative embolism dislocating from the cardiac chambers/aorta or combination of these two processes.…”

Section: Journal Of Neurology and Neuroscience Issn 2171-6625mentioning

confidence: 99%

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CT Findings of Early Post Operative Neurological Complication of Cardiovascular Surgeries

Dashottar¹,

Singh²,

V³

2016

J Neurol Neurosci

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Introduction: The incidence of neurological complications related to cardiovascular surgeries is comparatively very high and associated with high morbidity and mortality. The aim of this study is to establish not only the use of non-contrast computed tomography in detecting the cause of neurological problems but also to evaluate the various spectrums of findings associated with various types of cardiovascular surgeries. Method:We retrospectively analyzed all the non-contrast computed tomography head of the postoperative cardio-vascular surgeries patients done in immediate postoperative period (<7days).Result: 45 (6.7%) patients developed neurological complications in the early post-operative period which comprised of our study group. Out of 45 patients, 08 (18%) patients were of pediatric age group ranging who underwent surgeries for congenital complex cardiac disorders. Out of 45 patients presenting with neurological symptoms, 15 (33%) patients had focal deficit (stroke) and 30 (77%) patients had non-focal deficit (like seizure, delirium or cognitive impairment). Stroke patients had more possibility to have positive CT scan findings than NFD. Out of 45 patients, 40 (88%) had positive CT scan findings and five patient had normal NCCT head. The various types of positive CT scan findings were-19 ischemic infarct, 04 intra-parenchymal hemorrhages, 17 subdural hemorrhage, 03 sub-arachnoid hemorrhage and 01 cerebro-vascular thrombosis. Conclusion:Non-contrast computed tomography of head is very useful in early postoperative neurological complication in cardio-vascular surgeries not only in diagnosing the complication but also managing accordingly.

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Complications of Cardiopulmonary Bypass and Cardioplegia

Creswell¹

2004

Complications in Cardiothoracic Surgery

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Cerebral complications after coronary artery bypass and heart valve surgery: Risk factors and onset of symptoms

Cited by 35 publications

References 21 publications

Cerebral near-infrared spectroscopy in adult heart surgery: systematic review of its clinical efficacy

Cerebral near-infrared spectroscopy in adult heart surgery: systematic review of its clinical efficacy

CT Findings of Early Post Operative Neurological Complication of Cardiovascular Surgeries

Complications of Cardiopulmonary Bypass and Cardioplegia

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