Neurological complications after cardiopulmonary bypass: An update

Introduction: Neurological complications are, at the present time, consider ed among the most important causes of morbidity and mortality after heart s urgery. We evaluated their importance and risk factors. Patients and Method s: We retrospectively reviewed 2,528 consecutive patients who underwent car diopulmonary bypass in a single center. In each one, we attended to previou s vascular risk factors, such as surgical and postoperative events. We cons idered four categories of neurologic outcome: (1) persistent neurological f ocal deficits, (2) stupor or coma, (3) temporary neurological focal deficit s, and (4) seizures. We carried out univariant and multivariant statistical analysis, looking for predictors of adverse neurologic events. Results: Ne urological complications occurred in 76 patients (3%); 36 of them (47%) had persistent neurological focal deficits, 18 (24%) stupor or coma, 18 (24%) temporary neurological focal deficits, and 27 (36%) seizures. Twenty-two pa tients with cerebral adverse outcomes died (29%), the overall mortality amo ng the 2,528 cases being 5%. Predictors of risk were aortic aneurysm and ao rtic valve surgery, advanced age, female sex, and the use of intra-aortic b alloon pump. A longer hospitalization time was noticed among patients with neurological side effects. Discussion: Neurological complications are commo n and serious after heart surgery, as we have noticed with this series, the largest up to now, according to our review of the literature. They increas e perioperative mortality and hospitalization time. Neurological morbidity and risk factors in our study are similar to those previously published.