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Neurological and Cognitive Sequelae of Cardiac Surgery

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Brain Protection in Cardiac Surgery

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Abstract

Over the last 50 years, heart surgery, and coronary artery bypass grafting (CABG) in particular, has been a remarkable success story. John Gibbon and his wife, who were instrumental in the development of the cardiopulmonary bypass pump, were close family friends of one of us (GMcK), so as a youngster he heard about its early trials and tribulations. Years later, as a neurologist, he became increasingly aware of the neurological problems associated with CABG and other heart surgery procedures. This review is based primarily on our group’s prospective analyses of the neurological problems associated with heart surgery at Johns Hopkins Hospital, initiated in 1992, and carried out continuously since that time. We have confined our remarks primarily to CABG and valve surgery, and we do not comment on pediatric heart surgery, aortic surgery, or heart transplantation. We have divided these potential neurologic outcomes as: stroke; encephalopathy; short-term cognitive problems; and long-term cognitive problems, and the incidence of each in our patient population is shown in Fig. 3.1.

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Acknowledgements

We wish to thank Dr. Pamela Talalay and Ms. Maryanne M. Bailey for their assistance in preparation of this document. In addition, our work over the years has been supported by the following grants: National Institute of Neurological Disorders and Stroke (#35610), National Institutes of Health, Bethesda, MD; the Charles A. Dana Foundation (#90030633), New York, N.Y.; and the Johns Hopkins Medical Institution GCRC grant RR 00052.

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Authors and Affiliations

  1. Department of Neurology, Johns Hopkins University, Baltimore, Maryland, USA

    Guy M. McKhann

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  1. Guy M. McKhann
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  2. Rebecca F. Gottesman
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  3. Maura A. Grega
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  4. Willam A. Baumgartner
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  5. Ola A. Selnes
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Correspondence to Guy M. McKhann .

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Editors and Affiliations

  1. Dept. Cardiothoracic Surgeon, Queen Elizabeth Hospital, Birmingham, B15 2TH, United Kingdom

    Robert S. Bonser

  2. Cardiothoracic Surgery, Beaumont Road 208, Birmingham, B30 1NX, United Kingdom

    Domenico Pagano

  3. Klinik für Herz-, Thorax-,, Transplantations- und Gefäßchirurgie, Medizinische Hochschule Hannover (MHH), Carl-Neuberg-Str. 1, Hannover, 30625, Germany

    Axel Haverich

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McKhann, G.M., Gottesman, R.F., Grega, M.A., Baumgartner, W.A., Selnes, O.A. (2011). Neurological and Cognitive Sequelae of Cardiac Surgery. In: Bonser, R., Pagano, D., Haverich, A. (eds) Brain Protection in Cardiac Surgery. Springer, London. https://doi.org/10.1007/978-1-84996-293-3_3

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  • DOI: https://doi.org/10.1007/978-1-84996-293-3_3

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