Central nervous system injury associated with cardiac surgery.
Millions of individuals with coronary artery or valvular heart disease have been given a new chance at life by heart surgery, but the potential for neurological injury is an Achilles heel. Technological advancements and innovations in surgical and anaesthetic technique have allowed us to offer surgical treatment to patients at the extremes of age and infirmity-the group at greatest risk for neurological injury. Neurocognitive dysfunction is a complication of cardiac surgery that can restrict the improved quality of life that patients usually experience after heart surgery. With a broader understanding of the frequency and effects of neurological injury from cardiac surgery and its implications for patients in both the short term and the long term, we should be able to give personalised treatments and thus preserve both their quantity and quality of life. We describe these issues and the controversies that merit continued investigation.
Newman
Mark F
MF
Department of Anesthesiology, Duke University Medical Center, Durham, NC 277110, USA. newma005@mc.duke.edu
Mathew
Joseph P
JP
Grocott
Hilary P
HP
Mackensen
G Burkhard
GB
Monk
Terri
T
Welsh-Bohmer
Kathleen A
KA
Blumenthal
James A
JA
Laskowitz
Daniel T
DT
Mark
Daniel B
DB
D003072:Cognition Disorders / Q000209:etiology*; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000601:surgery*; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology*; D011788:Quality of Life; D012307:Risk Factors; D020521:Stroke / Q000191:economics / Q000209:etiology*