Risk Factors of Neurologic Complications After Coronary Artery Bypass Grafting.
- Author:
Kye Hyeon PARK
1
;
Hurn CHAE
;
Choong Gyu PARK
;
Tae Gook JUN
;
Pyo Won PARK
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine.
- Publication Type:Original Article
- Keywords:
Coronary artery bypass;
Cerebrovascular disease;
Risk factors;
Postoperative complications
- MeSH:
Aorta;
Aorta, Thoracic;
Atherosclerosis;
Brain Death;
Cardiopulmonary Bypass;
Carotid Stenosis;
Catheterization;
Cerebral Infarction;
Consciousness;
Coronary Artery Bypass*;
Coronary Vessels*;
Humans;
Incidence;
Intellectual Disability;
Ischemic Attack, Transient;
Multivariate Analysis;
Myocardial Infarction;
Neurologic Examination;
Paralysis;
Plaque, Atherosclerotic;
Postoperative Complications;
Retrospective Studies;
Risk Factors*;
Stroke
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
1999;32(9):790-798
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: As the early outcome after coronary artery bypass grafting(CABG) has been stabilized, neurologic complication has now become one of the most important morbidity. The aim of this study was to find out the risk factors associated with the neurologic complications after CABG. MATERIAL AND METHOD: In 351 patients who underwent CABG, the incidence and features of neurologic complications, with associated perioperative risk factors, were retrospectively reviewed. Neurologic complication was defined as a new cerebral infarction confirmed by postoperative neurologic examination and radiologic studies, or delayed recovery of consciousness and orientation for more than 24 hours after the operation. RESULT: Neurologic complications occurred in 18 patients(5.1%), of these nine(2.6%) were diagnosed as having new cerebral infarctions(stroke). Stroke was manifested as motor paralysis in four patients, mental retardation or orientation abnormality in four, and brain death in one. Statistical analysis revealed the following variables as significant risk factors for neurologic complications by both univariate and multivariate analyses: cardiopulmonary bypass longer than 180 minutes, atheroma of the ascending aorta, carotid artery stenosis detected by Duplex sonography, and past history of cerebrovascular accident or transient ischemic attack. Age over 65 years, aortic calcification detected by simple X-ray, and intraoperative myocardial infarction were significant risk factors by univariate analysis only. Neither the severity of carotid artery stenosis nor technical modifications such as cannulation of the aortic arch or single clamp technique, which were expected to affect the inciden e of neurologic complications, had significant relationship with the incidence. CONCLUSION: This study confirmed the strong association between neurologic complications after CABG and atherosclerosis of the arterial system. Therefore, to minimize the incidence of neurologic complications, systematic evaluation focused on atheroscleroti.
