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  • Updated 07.06.2020
  • Released 11.15.1996
  • Expires For CME 07.06.2023

Cardiovascular procedures: neurologic complications

Introduction

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

Overview

The number of patients undergoing cardiac procedure has been increasing. Ischemic strokes, diffuse encephalopathy, and altered cognitive status are important neurologic complications of cardiac procedures. Neurologists are often called for consult before or after 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. Neurologic complications have been recognized as an important cause of perioperative 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, cardiac valve procedures, cardiac catheterization for percutaneous coronary interventions, radiofrequency ablative procedures, patent foramen ovale closures, and cardiac transplantation.

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