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Cerebral complications of cardiac surgery using cardiopulmonary bypass

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Abstract

The cerebral complications of cardiac surgery using cardiopulmonary bypass are of increasing importance in the practice of cardiac surgery. These complications may be manifested neurologically or neuropsychologically. Cerebral damage may be investigated using pathological, physiological, biochemical or imaging techniques.

Attention is currently being focussed on interventions to reduce not only the severe neurological sequelae seen rarely after cardiopulmonary bypass but also to reduce the more widespread neuropsychological or intellectual deficit seen. Interventions may be primarily either in the equipment used such as with the use of membrane as opposed to bubble oxygenators or with new pharmacological agents such as aspartate receptor antagonists.

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References

  1. Returns of the UK Cardiac Surgical Register. The Society of Thoracic and Cardiovascular Surgeons of Great Britain and Ireland, 1984.

  2. Bruer AC, Furlan AJ, Hanson NR, Lederman RJ, Loop FD, Cosgrove DM, Estafanous FG.Central nervous system complications of coronary artery bypass graft surgery: prospective analysis of 421 patients. Stroke 1983;14: 682–687.

    Google Scholar 

  3. Shaw P, Bates D, Carlidge NEF, Heaviside D, French JM, Julian JG, Shaw DA.Early neurological complications of coronary artery bypass surgery. BMJ 1985;291: 1384–1387.

    PubMed  CAS  Google Scholar 

  4. Taylor KM. Editorial.Brain damage during open heart surgery. Thorax 1982;37: 873–876.

    Article  PubMed  CAS  Google Scholar 

  5. Aberg T.Effect of open heart surgery on intellectual function. Scand J Thorac Cardiovasc Surg 1975;15 (Suppl): 1–63.

    Google Scholar 

  6. Savageau JA, Stanton BA, Jenkins CD, Klein MD.Neuropsychological dysfunction following elective cardiac operation. I. Early assessment. J Thorac Cardiovasc Surg 1982;84: 585–594.

    PubMed  CAS  Google Scholar 

  7. Savageau JA, Stanton BA, Jenkins CD, Frater RWM.Neuropsychological dysfunction following elective cardiac operation. II. A six month reassessment. J Thorac Cardiovasc Surg 1982; 84; 595–600.

    PubMed  CAS  Google Scholar 

  8. Shaw PJ, Bates D, Cartlidge NEF, French JM, Heaviside D, Julian DG, Shaw DA.Early intellectual dysfunction following coronary artery bypass surgery. Quart J Med 1986;58: 59–68.

    PubMed  CAS  Google Scholar 

  9. Shaw PJ, Bates D, Cartlidge NEF, French JM, Heaviside D, Julian DG, Shaw DA.Long term intellectual dysfunction following coronary artery bypass surgery: a six month follow-up study. Quart J Med 1987;62: 259–268.

    PubMed  CAS  Google Scholar 

  10. Smith PLC, Treasure T, Newman SP, Joseph PL, Ell PJ, Schneidau A, Harrison MJC.Cerebral consequences of cardiopulmonary bypass. Lancet 1986;1: 823–825.

    Article  PubMed  CAS  Google Scholar 

  11. Sotaneimi KA, Monohen H, Hokkanen TE.Long term cerebral outcome after open heart surgery. Stroke 1987;3: 410–416.

    Google Scholar 

  12. Pearson DT, Carter RF, Hammo MB, Waterhouse PS.Gaseous microemboli during open heart surgery. In: Longmore DB (ed)Towards Safer Cardiac Surgery. Lancester: MTP Press. 1981; 327–338.

    Google Scholar 

  13. Dutton RC, Edmunds LH, Hutchinson JC, Roe BB.Platelet aggregate emboli produced in patients during cardiopulmonary bypass with membrane and bubble oxygenators and blood filters. J Thorac Cardiovasc Surg 1974;67: 258–265.

    PubMed  CAS  Google Scholar 

  14. Blauth C, Arnold J, Kohner EM, Taylor KM.Retinal microembolism during cardiopulmonary bypass demonstrated by fluorescein angiography. Lancet 1986;ii: 837–839.

    Article  Google Scholar 

  15. Muraoka R, Tokota M, Aoshima M, Kyoku I, Nomoto S.Subclinical changes in brain morphology following cardiac operations as reflected by computed tomographic scans of the brain. J Thorac Cardiovasc Surg 1981;81: 364–369.

    PubMed  CAS  Google Scholar 

  16. Aguilar MG, Gerbode F, Hill JD.Neuropathologic complications of cardiac surgery. J Thorac Cardiovasc Surg 1971;61: 676–685.

    PubMed  CAS  Google Scholar 

  17. Aberg T, Ronquist G, Tyden H, Ahlund P, Bergstrom K.Release of adenylate kinase into cerebrospinal fluid during open heart operations and its relation to post operative intellectual function. Lancet 1982;1: 1139–1142.

    Article  PubMed  CAS  Google Scholar 

  18. Taylor KM, Devlin BJ, Mittra SM, Gillian JG, Brannan JJ, McKenna JM.Assessment of cerebral damage during open heart surgery. A new experimental model. Scand J Thorac Cardiovasc Surg 1980;14: 197–203.

    PubMed  CAS  Google Scholar 

  19. Henriksen L, Hjelms E, Lindeburgh T.Cerebral blood flow measured in man by intra-arterially injected 133Xe: evidence suggestive of intraoperative microembolism. J Thorac Cardiovasc Surg 1983;86: 202–208.

    PubMed  CAS  Google Scholar 

  20. Govier AC, Reves JG, McKay RD, Karp RB, Zorn GL, Morawetz RB, Smith RL, Adams H, Freeman AM.Factors and their influence on regional cerebral blood flow during non pulsatile cardiopulmonary bypass. Ann Thorac Surg 1984;38: 592–600.

    Article  PubMed  CAS  Google Scholar 

  21. Henriksen L.Evidence suggestive of diffuse brain damage following cardiac operations. Lancet 1984;i: 816–820.

    Article  Google Scholar 

  22. Smith PLC.The cerebral complications of coronary artery bypass surgery. Ann Roy Coll Surg Engl 1988;70: 212–216.

    CAS  Google Scholar 

  23. Sotaneimi KA.Five year neurological and EEG outcome after open heart surgery. J Neurol Neurosurg & Psychol 1985;48: 569–575.

    Google Scholar 

  24. Aris A, Solanes H, Camara ML, Junque C, Escartin A, Caralps JM.Arterial line filtration during cardiopulmonary bypass. Neurologic, neuropsychologic and haematologic studies. J Thorac Cardiovasc Surg 1986;91: 526–533.

    PubMed  CAS  Google Scholar 

  25. Taylor KM.Pathophysiology of brain damage during open heart surgery. Texas Heart Institute J 1986;13: 91–96.

    CAS  Google Scholar 

  26. Radegran K, Ahren C, Teger-Nilsson AC.Prostacyclin infusion during extracorporeal circulation for coronary bypass. J Thorac Cardiovasc Surg 1982;83: 205–211.

    PubMed  CAS  Google Scholar 

  27. Kochar A, Zivin JA, Lyden PD, Mazzarella V.Glutamate antagonist therapy reduces neurologic deficits produced by focal central nervous system ischaemia. Arch Neurol 1988;45: 148–153.

    Google Scholar 

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Smith, P.L. Cerebral complications of cardiac surgery using cardiopulmonary bypass. Indian J Thorac Cardiovasc Surg 5, 6–11 (1987). https://doi.org/10.1007/BF02664048

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