Beating heart surgery: why expect less central nervous system morbidity?

Abstract

BACKGROUND:

The incidence and etiology of brain dysfunction after conventional coronary artery bypass surgery using cardiopulmonary bypass (CPB) are reviewed.

METHODS:

Stroke rates and incidences of cognitive dysfunction from various studies are considered. Mechanisms of injury including cerebral embolization as detected by transcranial Doppler and retinal angiography, and imaging-based evidence for postoperative cerebral edema, are discussed. Preliminary results from a prospective clinical trial assessing cognitive dysfunction after beating heart versus conventional coronary artery bypass with CPB are discussed.

RESULTS:

Initial evidence for lower overall postoperative morbidity, and for a lower incidence of cognitive dysfunction specifically, after nonpump coronary revascularization is presented.

CONCLUSIONS:

Beating heart surgery results in less potential for generation of cerebral emboli and appears to produce a lower incidence of cognitive dysfunction in both short- and intermediate-term postoperative follow-up periods as compared with conventional coronary artery bypass surgery using CPB.

• Authors: J M Murkin, W D Boyd, S Ganapathy, S J Adams, R C Peterson
• Journal: The Annals of thoracic surgery (Ann Thorac Surg) Vol. 68 Issue 4 Pg. 1498-501 (Oct 1999) ISSN: 0003-4975 [Print] Netherlands
• PMID: 10543553 (Publication Type: Journal Article, Review)

Topics

• Cardiopulmonary Bypass
• Coronary Artery Bypass (methods)
• Heart Arrest, Induced
• Humans
• Postoperative Complications (etiology, prevention & control)
• Risk Factors
• Stroke (etiology, prevention & control)
• Treatment Outcome