Risk Factors and Solutions for the Development of Neurobehavioral Changes After Coronary Artery Bypass Grafting John W Hammon, MD, David A Stump, PhD,

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Presentation transcript:

Risk Factors and Solutions for the Development of Neurobehavioral Changes After Coronary Artery Bypass Grafting John W Hammon, MD, David A Stump, PhD, Neal D Kon, MD, A.Robert Cordell, MD, Allen S Hudspeth, MD, Timothy E Oaks, MD, Robert F Brooker, MD, Anne T Rogers, MD, Rosie Hilbawi, MS, Laura H Coker MSN, B.Todd Troost, MD The Annals of Thoracic Surgery Volume 63, Issue 6, Pages 1613-1617 (June 1997) DOI: 10.1016/S0003-4975(97)00261-0

Fig. 1 Ultrasonic perturbations detected by a 5-MHz continuous-wave Doppler device are associated with both gaseous and particulate emboli. In this view, a 5-second monitoring period was captured immediately after cross-clamp release and an embolic shower was detected in the left carotid artery. The Annals of Thoracic Surgery 1997 63, 1613-1617DOI: (10.1016/S0003-4975(97)00261-0)

Fig. 2 The effect of increasing age on neuropsychologic outcome at 5 to 7 days and 1 month after coronary artery bypass grafting (CABG). Patients at age 50 years with deficits on two or more tests have a 67% chance of becoming normal at 1 month. By age 70 years that chance drops to less than 60%. The Annals of Thoracic Surgery 1997 63, 1613-1617DOI: (10.1016/S0003-4975(97)00261-0)

Fig. 3 Epiaortic and transesophageal echocardiographic scanning provides an additional level of protection to older patients who may face higher risks of brain injury owing to a greater likelihood of embolization secondary to aortic atheroma. The Annals of Thoracic Surgery 1997 63, 1613-1617DOI: (10.1016/S0003-4975(97)00261-0)

Fig. 4 The percentage of patients with neuropsychologic deficits in group B at both 5 to 7 days and 1 month. (CABG = coronary artery bypass grafting.) The Annals of Thoracic Surgery 1997 63, 1613-1617DOI: (10.1016/S0003-4975(97)00261-0)