[A study of neurological complications after coronary artery bypass grafting].
OBJECTIVE
To prospectively investigate the neurological complications (NC) after off-pump coronary artery bypass grafting (OPCABG), including the kinds of NC and their mobility, risk factors, prevention and treatment.


METHODS
A total of 55 consecutive patients with undergoing OPCABG were evaluated from March to June 2006 at the Department of Cardiosurgery in Beijing Anzhen Hospital. Risk factors of NC were collected before operation. Nervous system physical examination, the NIH Stroke Scale (NIHSS) score evaluation, cognitive tests, imaging examination (MRI, MRA and f-MRI), anxious and depression scale were performed before and after OPCABG. NC and their kinds were identified after surgery. According to the presence or absence of NC after the operation, the patients were divided into two groups, and univariate analysis was used between the two groups. P < 0.05 was considered of statistically significant difference.


RESULTS
(1) 2 cases of ischemic stroke developed after surgery (2/55), but there no case of mortality. The risk factors were not statistically different between the two groups (P > 0.05); (2) For all the patients, cognitive evaluation was normal and unchanged before and after surgery (P > 0.05), including Mini-Mental State Examination (MMSE), Clinical dementia rating (CDR) and Global Deterioration Scale (GDS); (3) Except the 2 cases of stroke, the others were normal and had no change on MRI, MRA, and f-MRI (P > 0.05) before and after surgery; (4) 7 patients with slight anxiety and one with slight depression before operation recovered completely after surgery without treatment. Both the Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were normal and unchanged before and after surgery (P > 0.05).


CONCLUSIONS
2 cases of ischemic stroke were found among 55 patients undergoing OPCABG (2/55) and there was no mortality. There was no obvious change of cognitive function, imaging finding, anxiety and depression before and after the operation (P > 0.05). OPCABG is relatively safe for nervous system, but more exploratory work and clinical data are needed.
Bi
Qi
Q
Department of Neurology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China. biqidoctor@163.com
Li
Qin
Q
Zhang
Zhao-Qi
ZQ
Gu
Cheng-Xiong
CX
Ma
Xiao-Hai
XH
D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000188:drug therapy / Q000517:prevention & control; D008875:Middle Aged; D009460:Neurologic Examination; D011183:Postoperative Complications / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control; D011446:Prospective Studies