Nevrologiske skader og funksjonsforstyrrelser etter elektiv hjertekirurgi

Abstract

Concept: adverse neurological outcomes after cardiac surgery, although well-known, are still relatively common. In average, about 5 % of the adult cardiac surgeries end up in stroke and about 15 % has some kind of global or functional cerebral dysfunction as sequelae. Cardiovascular diseases are one of today’s leading causes of morbidity and mortality and the number of performed cardiac surgery worldwide is therefore increasing. The aim of this study was to evaluate the adverse neurological outcomes after cardiac surgery, with a special interest in approaches that can be utilized in preventing these kinds of complications.

Design: prospective cohort study of 50 patients undergoing elective coronary bypass surgery and/or aortic valve replacement. The study population was admitted for elective cardiac surgery at Oslo University Hospital, Rikshospitalet, during the period of 2011-2012.

Results: None of the patients developed severe neurological damage like stroke or type one brain injury. Six patients (12 %) experienced some kind of type 2 brain injury and four (8 %) patients had minor peripheral neuronal damage. Total prevalence of neurological complications in this study was 20 %, not far from the actual estimated prevalence of about 20-40 %.

Conclusions: adverse neurological outcomes are common after cardiac surgery and more importantly they show great diversity. Patient population, operation method, the skills of the surgeons, technical support and peri-operative care all has impact on outcome. Our main goal should be to give the patient the best possible treatment at lowest risk – and that means that health professionals should keep each other updated about the patient they are working with.