Cerebral Dysfunction in Elective Coronary Surgery

  • W. A. Stertmann
  • C. Lammers
  • R. Moosdorf
  • C. R. Hornig
  • H. H. Scheld


In the sixties and early seventies several authors reported neurological complications following open-heart surgery. A primary matter of discussion was valid preoperative investigation aimed at preventing neurological complications among the increasing number of patients undergoing elective coronary artery bypass grafting (CABG). Controversy exists as to whether patients with asymptomatic carotid bruits have an increased risk of perioperative stroke at the time of cardiac surgery, especially when prolonged hypotension occurs. Moreover, perioperative strokes often occur in patients who were not suspected of having carotid disease. Furthermore, significant carotid occlusive disease may be present without signs or symptoms, and thus remain undiagnosed.


Carotid Stenosis Carotid Artery Stenosis Carotid Artery Disease Carotid Disease Cerebral Dysfunction 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    R. M. Bojar, H. Najafi, G. A. Delaria, C. Serry, and M. D. Goldin, Neurological complication of cornary revascularisation, Ann. Thorac Surg. 36: 427 – 432 (1983).PubMedCrossRefGoogle Scholar
  2. 2.
    A. C. Breuer, A. J. Furlan, M. R. Hanson, R. J. Lederman, F. D. Loop, D. M. Cosgrove, R. L. Greenstreet and F. G. Estafanous, Central nervous system complication of coronary artery bypass graft surgery: Prospective analysis of 421 patients. Stroke, 14: 682 – 687 (1983).Google Scholar
  3. 3.
    A. J. Furlan and S. C. Jones, Central nervous system complications related to open heart surgery, in: “The Heart and Stroke,” A. J. Furlan, ed., Springer, Berlin, Heidelberg (1987).Google Scholar
  4. 4.
    P. J. Shaw, D. Bates, N. E. F. Cartlidge, J. M. French, D. Heaviside, D. G. Julian and D. A. Shaw, Neurologic and neuropsychological morbidity following major surgery: Comparison of coronary artery bypass and peripheral vascular surgery. Stroke, 18: 700 – 707 (1987).Google Scholar
  5. 5.
    C. E. Coffey, W. Massey, K. B. Roberts, S. Curtis, R. H. Jones and D. B. Pryer, Natural history of cerebral complications of coronary artery bypass graft surgery. Neurology, 33: 1416 – 1421 (1983).Google Scholar
  6. 6.
    F. Gonzales-Scarano and H. I. Hurtig, Neurologic complications of coronary artery bypass grafting: A casecontrol study. Neurology, 31: 1032 – 1035 (1981).Google Scholar
  7. 7.
    N. R. Hertzer, F. D. Loop, P. C. Taylor and E. G. Beven, Staged and combined surgical approach to simultaneous carotid and coronary vascular disease. Surgery, 85: 803 - 811 (1978)Google Scholar
  8. 8.
    P. Sergeant, W. Flameng and R. Suy, The cerebral risk in coronary surgery. Stroke19: 143 (1988).Google Scholar
  9. 9.
    R. B. Barnes, P. R. Liebman, P. B. Marszalek, C. L. Kirk and M. H. Goldman, The natural history of asymptomatic carotid disease in patients undergoing cardiovascular surgery. Surgery, 90: 1075 – 1083 (1981).Google Scholar
  10. 10.
    P. J. Breslau, G. Fell, T. D. Ivey, W. W. Bailey, D. W. Miller and D. E. Strandness, Carotid arterial disease in patients undergoing coronary artery bypass operations, J. Thorac. Cardiovasc. Surg., 82:765–767 (1983).Google Scholar
  11. 11.
    W. D. Turnipseed, H. A. Berkoff and F. O. Beizer, Postoperative stroke in cardiac and peripheral vascular disease, Ann. Surg., 192:365–368 (1980).PubMedCrossRefGoogle Scholar
  12. 12.
    N. R. Hertzer, F. D. Loop and E. G. Beven, Management of coexistent carotid and coronary artery disease: A surgical viewpoint, in: “The Heart and Stroke,” A. J. Furlan, ed.. Springer, Berlin, Heidelberg (1987).Google Scholar
  13. 13.
    K. Minami, K. S. Sagoo, T. Breymann, D. Fassbender, M. Schwerdt and R. Korfer. Operative strategy in combined coronary and carotid artery disease, J. Thorac. Cardiovasc. Surg. 95:303–309 (1988). PubMedGoogle Scholar
  14. 14.
    T. D. Ivey, D. E. Strandness, D. B. Williams, Y. Langlois, G. A. Misbach and A. P. Kurse, Management of patients with carotid bruit undergoing cardiopulmonary bypass, J. Thorac. Cardiovasc. Surg., 87:183–189 (1984). PubMedGoogle Scholar
  15. 15.
    R. W. Emery, L. H. Cohn, A.D. Whittemore, J. A. Mannick, N. P. Couch and J. J. Collins, Coexistent carotid and coronary artery disease. Arch. Surg., 118:1033–1038 (1983).Google Scholar
  16. 16.
    V. M. Bernhard, W. D. Johnson and J. J. Peterson, Carotid artery stenosis: Association with surgery for coronary artery disease. Arch. Surg., 105:837–840 (1972).PubMedGoogle Scholar

Copyright information

© Plenum Press, New York 1990

Authors and Affiliations

  • W. A. Stertmann
    • 1
  • C. Lammers
    • 2
  • R. Moosdorf
    • 1
  • C. R. Hornig
    • 2
  • H. H. Scheld
    • 1
  1. 1.Department of Cardiovascular SurgeryUniversity Hospital of GiessenGiessenFederal Republic of Germany
  2. 2.Department of NeurologyUniversity Hospital of GiessenGiessenGermany

Personalised recommendations