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  • Updated 11.23.2023
  • Released 11.15.1996
  • Expires For CME 11.23.2026

Cardiovascular procedures: neurologic complications



The number of cardiac procedures has increased rapidly. Neurologists are often called for consultation 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 cardiac procedures has been steadily increasing and, along with them, the perioperative neurologic complications. Neurologists are often consulted for both their prevention and management.

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, closure of the patent foramen ovale, and cardiac transplantation.

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