Adverse cerebral outcomes after coronary bypass surgery

New England Journal of Medicine

Volumn 335, Issue 25, 1996, Pages 1857-1863

  Roach, Gary W ^a   Kanchuger, Marc ^b   Mangano, Christina Mora ^c,i   Newman, Mark ^d   Nussmeier, Nancy ^e   Wolman, Richard ^f   Aggarwal, Anil ^g   Marschall, Katherine ^b   Graham, Steven H ^h   Ley, Catherine ⁱ   Ozanne, Gerard ^j   Mangano, Dennis T ^j  

^a KAISER PERMANENTE MEDICAL CENTER   (United States)

^b NEW YORK UNIVERSITY   (United States)

^c STANFORD UNIVERSITY   (United States)

^d DUKE UNIVERSITY   (United States)

^e Mercy Medical Center   (United States)

^f VIRGINIA COMMONWEALTH UNIVERSITY SCHOOL OF MEDICINE   (United States)

^g CLEMENT J ZABLOCKI VETERANS AFFAIRS MEDICAL CENTER   (United States)

^h UNIVERSITY OF PITTSBURGH   (United States)

ⁱ Ischemia Research and Education Foundation   (United States)

^j SAN FRANCISCO VETERANS AFFAIRS MEDICAL CENTER   (United States)

more..

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; AGED; AMNESIA; AORTA ATHEROSCLEROSIS; ARTICLE; BRAIN INJURY; BRAIN ISCHEMIA; CLINICAL TRIAL; CORONARY ARTERY BYPASS SURGERY; DISEASE CLASSIFICATION; HUMAN; INCIDENCE; INTELLECTUAL IMPAIRMENT; MAJOR CLINICAL STUDY; NEUROLOGICAL COMPLICATION; PREDICTION; PRIORITY JOURNAL; SEIZURE; STROKE; TREATMENT OUTCOME;

AGE FACTORS; AGED; ARTERIOSCLEROSIS; BRAIN DISEASES; CEREBROVASCULAR DISORDERS; COMA; CORONARY ARTERY BYPASS; HUMANS; INCIDENCE; INTRAOPERATIVE COMPLICATIONS; LOGISTIC MODELS; MEMORY DISORDERS; MYOCARDIAL ISCHEMIA; POSTOPERATIVE COMPLICATIONS; PROSPECTIVE STUDIES; RISK FACTORS; SEIZURES;

EID: 0141469033     PISSN: 00284793     EISSN: None     Source Type: Journal    
DOI: 10.1056/NEJM199612193352501     Document Type: Article

References (49)

1. Mangano DT. Cardiovascular morbidity and CABG surgery - a perspective: epidemiology, costs, and potential therapeutic solutions. J Card Surg 1995;10:Suppl:366-8.
2. Idem. Perioperative cardiac morbidity. Anesthesiology 1990;72:153-84.
3. Mora Mangano CT, Mangano DT. Perioperative stroke, encephalopathy and CNS dysfunction. J Intensive Care Med (in press).
4. Mora CT, Murkin JM. The central nervous system: responses to cardiopulmonary bypass. In: Mora CT, ed. Cardiopulmonary bypass: principles and techniques of extracorporeal circulation. New York: Springer-Verlag, 1995:114-46.
5. Herskowitz A, Mangano DT. The inflammatory cascade: a final common pathway for perioperative injury? Anesrhesiology 1996;85:454-7.
6. Gardner TJ, Horneffer PJ, Manolio TA, et al. Stroke following coronary artery bypass grafting: a ten-year study. Ann Thorac Surg 1985;40:574-81.
7. Tuman KJ, McCarthy RJ, Najafi H, Ivankovich AD. Differential effects of advanced age on neurologic and cardiac risks of coronary artery operations. J Thorac Cardiovasc Surg 1992;104:1510-7.
8. Shaw PJ, Bates D, Cartlidge NEF, Heaviside D, Julian DG, Shaw DA. Early neurological complications of coronary artery bypass surgery. BMJ 1985;291:1384-7.
9. Sotaniemi KA. Cerebral outcome after extracorporeal circulation: comparison between prospective and retrospective evaluations. Arch Neurol 1983;40:75-7.
10. Weintraub WS, Jones EL, Craver J, Guyton R, Cohen C. Determinants of prolonged length of hospital stay after coronary bypass surgery. Circulation 1989;80:276-84.
11. Bozdogan H. Model selection and Akaike's information criterion (AIC): the general theory and its analytical extensions. Psychometrika 1987;52:345-70.
12. Hosmer DW Jr, Lemeshow S. Applied logistic regression. New York: John Wiley, 1989.
13. Newman MF, Wolman R, Kanchuger M, et al. Multicenter preoperative stroke risk index for patients undergoing coronary artery bypass graft surgery. Circulation 1996;94:Suppl II:II-74-II-80.
14. Mathew JP, Parks R, Savino JS, et al. Atrial fibrillation following coronary artery bypass grafting surgery: predictors, outcomes, and resource utilization. JAMA 1996;276:300-6.
15. Lynn GM, Stefanko K, Reed JF III, Gee W, Nicholas G. Risk factors for stroke after coronary artery bypass. J Thorac Cardiovasc Surg 1992;104: 1518-23.
16. Breuer AC, Furlan AJ, Hanson MR, et al. Central nervous system complications of coronary artery bypass graft surgery: prospective analysis of 421 patients. Stroke 1983;14:682-7.
17. Sakakibara Y, Shiihara H, Terada Y, Ino T, Wanibuchi Y, Furuta S. Central nervous system damage following surgery using Cardiopulmonary bypass - a retrospective analysis of 1386 cases. Jpn J Surg 1991;21:25-31.
18. Sotaniemi KA, Juolasmaa A, Hokkanen ET. Neuropsychologic outcome after open-heart surgery. Arch Neurol 1981;38:2-8.
19. Oka Y, Inoue T, Hong Y, Sisto DA, Strom JA, Frater RWM. Retained intracardiac air: transesophageal echocardiography for definition of incidence and monitoring removal by improved techniques. J Thorac Cardiovasc Surg 1986;91:329-38.
20. Slogoff S, Girgis KZ, Keats AS. Etiologic factors in neuropsychiatric complications associated with cardiopulmonary bypass. Anesth Analg 1982;61:903-11.
21. Bull DA, Neumayer LA, Hunter GC, et al. Risk factors for stroke in patients undergoing coronary artery bypass grafting. Cardiovasc Surg 1993;1:182-5.
22. Bar-El Y, Goor DA. Clamping of the atherosclerotic ascending aorta during coronary artery bypass operations: its cost in strokes. J Thorac Cardiovasc Surg 1992;104:469-74.
23. Marschall K, Kanchuger M, Kessler K, et al. Superiority of transesophageal echocardiography in detecting aortic arch atheromatous disease: identification of patients at increased risk of stroke during cardiac surgery. J Cardiothorac Vasc Anesth 1994;8:5-13.
24. Wareing TH, Davila-Roman VG, Barzilai B, Murphy SF, Kouchoukos NT. Management of the severely atherosclerotic ascending aorta during cardiac operations: a strategy for detection and treatment. J Thorac Cardiovasc Surg 1992;103:453-62.
25. Katz ES, Tunick PA, Rusinek H, Ribakove G, Spencer FC, Kronzon I. Protruding aortic atheromas predict stroke in elderly patients undergoing cardiopulmonary bypass: experience with intraoperative transesophageal echocardiography. J Am Coll Cardiol 1992;20:70-7.
26. Ribakove GH, Katz ES, Galloway AC, et al. Surgical implications of transesophageal echocardiography to grade the atheromatous aortic arch. Ann Thorac Surg 1992;53:758-63.
27. Davila-Roman VG, Barzilai B, Wareing TH, Murphy SF, Kouchoukos NT. Intraoperative ultrasonographic evaluation of the ascending aorta in 100 consecutive patients undergoing cardiac surgery. Circulation 1991;84: Suppl III:III-47-III-53.
28. Mora CT, Henson MB, Weintraub WS, et al. The effect of temperature management during cardiopulmonary bypass on neurologic and neurophysiologic outcomes in patients undergoing coronary revascularization. J Thorac Cardiovasc Surg 1996;112:514-22.
29. Mills NL, Kverson CT. Atherosclerosis of the ascending aorta and coronary artery bypass: pathology, clinical correlates, and operative management. J Thorac Cardiovasc Surg 1991;102:546-53.
30. Aranki SH, Rizzo RJ, Adams DH, et al. Single-clamp technique: an important adjunct to myocardial and cerebral protection in coronary operations. Ann Thorac Surg 1994;58:296-303.
31. Ricotta JJ, Faggioli GL, Castilone A, Hassett JM. Risk factors for stroke after cardiac surgery: Buffalo Cardiac-Cerebral Study Group. J Vasc Surg 1995;21:359-64.
32. Alter M, Friday G, Lai SM, O'Connell J, Sobel E. Hypertension and risk of stroke recurrence. Stroke 1994;25:1605-10.
33. Jude B, Agraou B, McFadden KP, et al. Evidence for time-dependent activation of monocytes in the systemic circulation in unstable angina but not in acute myocardial infarction or in stable angina. Circulation 1994; 90:1662-8.
34. Zwart HH, Brainard JZ, DeWall RA. Ventricular fibrillation without left ventricular venting: observations in humans. Ann Thorac Surg 1975; 20:418-23.
35. Pugsley W, Klinger L, Paschalis C, Treasure T, Harrison M, Newman S. The impact of microemboli during cardiopulmonary bypass on neuropsychological functioning. Stroke 1994;25:1393-9.
36. Clark RE, Brillman J, Davis DA, Lovell MR, Price TRP, Magovern GJ. Microemboli during coronary artery bypass grafting: genesis and effect on outcome. J Thorac Cardiovasc Surg 1995;109:249-58.
37. Salomon NW, Page US, Bigelow JC, Krause AH, Okies JK, Metzdorff MT. Coronary artery bypass grafting in elderly patients: comparative results in a consecutive series of 469 patients older than 75 years. J Thorac Cardiovasc Surg 1991;101:209-18.
38. Acinapura AJ, Rose DM, Cunningham JN Jr, Jacobowitz IJ, Kramer MD, Zisbrod Z. Coronary artery bypass in septuagenarians: analysis of mortality and morbidity. Circulation 1988;78:Suppl I:I-179-I-184.
39. Fuse K, Makuuchi H. Early and late results of coronary artery bypass grafting in the elderly. Jpn Circ J 1988;52:460-5.
40. Naunheim KS, Fiore AC, Wadley JJ, et al. The changing profile of thepatient undergoing coronary artery bypass surgery. J Am Coll Cardiol 1988;11:494-8.
41. Lavy S, Melamed E, Bentin S, Cooper G, Rinot Y. Bihemispheric decreases of regional cerebral blood flow in dementia: correlation with age-matched normal controls. Ann Neurol 1978;4:445-50
42. Yamamoto M, Meyer JS, Sakai F, Yamaguchi F. Aging and cerebral vasodilator responses to hypercarbia: responses in normal aging and in persons with risk factors for stroke. Arch Neurol 1980;37:489-96.
43. 2 reactivity in stroke-age normal controls. Neurology 1983;33:391-9.
44. Newman MF, Croughwell ND, Blumenthal JA, et al. Effect of aging on cerebral autoregulation during cardiopulmonary bypass: association with postoperative cognitive dysfunction. Circulation 1994;90:Suppl II: II-243-II-249.
45. Heller SS, Frank KA, Malm JR, et al. Psychiatric complications of open-heart surgery: a re-examination. N Engl J Med 1970;28:1015-20.
46. Gold JP, Charlson ME, Williams-Russo P, et al. Improvement of outcomes after coronary artery bypass: a randomized trial comparing intraoperative high versus low mean arterial pressure. J Thorac Cardiovasc Surg 1995;110:1302-14.
47. Clark RE. Calculating risk and outcome: the Society of Thoracic Surgeons database. Ann Thorac Surg 1996;62:Suppl:S2-S5.
48. The Multicenter Study of Perioperative Ischemia (McSP1) Research Group. Effects of acadesine on the incidence of myocardial infarction and adverse cardiac outcomes after coronary artery bypass graft surgery. Anesthesiology 1995;83:658-73.
49. Mangano DT. Effects of acadesine on myocardial infarction, stroke and death following surgery: a meta-analysis of the five international randomized trials. JAMA (in press).