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  • Updated 07.21.2021
  • Released 11.15.1996
  • Expires For CME 07.21.2024

Cardiovascular procedures: neurologic complications

Introduction

Overview

The number of cardiac procedures has increased rapidly. Neurologists are often called for consult before or after cardiac procedures. Ischemic stroke, diffuse encephalopathy, and altered cognitive status are the most important neurologic complications of cardiac procedures.

Key points

• Most neurologic complications of cardiovascular procedures are due to embolism, hypoperfusion, seizures, infections, metabolic disturbances, or medication side effects.

• Ischemic stroke rate in the postoperative period is as high or even higher than intraoperatively.

• Brain MRI is more sensitive than head CT for detecting ischemic stroke.

• Peripheral nerve injury is mostly due to compression from a local hematoma and is usually transient.

Historical note and terminology

The number of patients undergoing cardiac procedures has been increasing, and neurologic complications are an important cause of perioperative morbidity. Neurologists are consulted not only to manage these complications but also to prevent them from occurring.

This review covers the neurologic complications of cardiovascular procedures, including coronary artery bypass graft surgery, cardiac valve procedures, cardiac catheterization for percutaneous coronary interventions, radiofrequency ablative procedures, patent foramen ovale closures, and cardiac transplantation.

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