Neurologic complications of open heart surgery. Computer-assisted analysis of 531 patients.

Cleveland, Ohio Neurologic problems occurring in patients undergoing open heart surgery are infrequent, but nevertheless tangible. Problems have included prolonged "metabolic" encephalopathies, cerebrovascular infarcts, seizures, peroneal palsies, and brachia l plexus injuries, to cite the m a i n examples. A l though there is a considerable literature concerning the neurologic findings associated with cardiac valve surgery and some data are available on the subject of the neurologic phenomenology associated with cardiac transplantation, there is v irtual ly no information on the subject of neurologic difficulties encountered in the patient population undergoing coronary artery bypass graft procedures. 1 -6 W i t h the large experience in open heart surgery at T h e Cleveland C l i n i c Foundation, it was decided to study prospectively a series of 5 3 1 patients who underwent various open heart procedures in an effort to identify the types of neurologic difficulties encountered, their frequency, and risk factors for neurologic compromise. T h e patients were studied by neurologists before and one or more times after open heart surgery. Four hundred fifty-one preoperative, operative, and postoperative variables were assessed. I n the myocardial revascularization group, 380 patients underwent bypass grafting for the first time and 38 for the second time.