Strokes, seizures and other neurological complications related to heart surgery account for "considerable morbidity and mortality," Loyola University Health System neurologists report in the November issue of the journal Hospital Practice.
Other complications include delirium, central nervous system infections, pituitary gland problems, spinal cord or peripheral nerve injuries, residual effects of anesthesia and medication toxicity.
Complications can involve any part of the central and peripheral nervous systems. "Neurologic complications are always a risk with cardiac surgery, especially in older patients who have other health problems," said Dr. José Biller, first author of the article and chairman of the Department of Neurology at Loyola University Chicago Stritch School of Medicine.
Strokes are the most common neurologic complication after cardiac surgery in adults. In children, seizures are the most common neurologic complication.
However, Biller said patients should not be afraid to undergo cardiac procedures. Many complications are rare. And despite the risks, cardiac surgeries generally "are highly beneficial and life-saving," he said.
Biller and colleagues summarized results of previously published studies. They examined neurologic complications related to cardiac catheterization exams, balloon angioplasties, ablation therapies for heart rhythm disorders, heart bypass surgeries, thoracic aortic surgeries, surgeries for congenital heart disease, cardiac valve surgeries, heart transplants, surgeries for heart tumors and procedures to close a hole in the heart called a patent foramen ovale.
"Neurologic complications remain an important cause of morbidity, hospitalization time and mortality following cardiac surgery and interventional cardiac procedures," Biller and his colleagues wrote. "Evaluation of these complications requires an orderly and systematic approach. Prompt identification of these deficits is key in planning appropriate evaluation and optimal management. Further research in this area is needed."
Co-authors are Dr. Sara Hocker of the Mayo Clinic Department of Neurology and Dr. Sarkis Morales-Vidal of Loyola's Department of Neurology.
- José Biller, MD; Sara Hocker, MD; And Sarkis Morales-Vidal, MD. Neurologic Complications of Cardiac Surgery and Interventional Cardiac Procedures. Hospital Practice, Volume 38: No.4 DOI: 10.3810/hp.2010.11.344
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