Cardiovascular procedures: neurologic complications

Kumar Rajamani MD (Dr. Rajamani of Wayne State University School of Medicine has no relevant financial relationships to disclose.)
Pawani Sachar MD (Dr. Sachar of Wayne State University School of Medicine has no relevant financial relationships to disclose.)
Steven R Levine MD, editor. (Dr. Levine of the SUNY Health Science Center at Brooklyn has received honorariums from Genentech for service on a scientific advisory committee and a research grant from Genentech as a principal investigator.)
Originally released November 15, 1996; last updated July 29, 2015; expires July 29, 2018

This article includes discussion of neurologic complications of cardiovascular procedures, cardiac transplantation, coronary artery bypass surgery, left-sided catheterization, and open cardiac surgery. The foregoing terms may include synonyms, similar disorders, variations in usage, and abbreviations.

Overview

Because of the increasing number and changing demographics of patients undergoing cardiac interventional and surgical procedures, neurologists are increasingly called on to consult on those with adverse neurologic outcomes. Despite improvements, ischemic strokes, diffuse encephalopathy, and cognitive changes are important complications of cardiac procedures. Newer modalities of imaging and successes in acute stroke treatment, including thrombolysis and the surgical and endovascular treatment of carotid stenosis, have both impacted the occurrence and management of these neurologic complications.

Key points

 

• Invasive cardiac procedures are being performed increasingly commonly.

 

• Central nervous system complications include strokes and cognitive changes.

 

• Awareness of risk factors and pathogenesis can be helpful in reducing these complications.

Historical note and terminology

The number of patients undergoing cardiac revascularization procedures is ever increasing. Advances in technology, anesthesia, and surgical techniques have reduced the mortality and morbidity associated with these cardiac procedures. Neurologic complications have been recognized as an important cause of postoperative morbidity. Neurologists are called on for consultations not only to assess and treat these complications but also increasingly to devise strategies to prevent them from occurring in the first place. This review covers the neurologic complications of cardiovascular procedures, including coronary artery bypass graft surgery (CABG), cardiac valve procedures, cardiac catheterization for percutaneous coronary interventions, radiofrequency ablative procedures, patent foramen ovale closures, and cardiac transplantation.

The content you are trying to view is available only to logged in, current MedLink Neurology subscribers.

If you are a subscriber, please log in.

If you are a former subscriber or have registered before, please log in first and then click select a Service Plan or contact Subscriber Services. Site license users, click the Site License Acces link on the Homepage at an authorized computer.

If you have never registered before, click Learn More about MedLink Neurology  or view available Service Plans.