Neurologic outcomes after coronary artery bypass grafting with and without cardiopulmonary bypass

John E. Scarborough, William White, Frantz E. Derilus, Joseph P. Mathew, Mark F. Newman, Kevin P. Landolfo

Research output: Contribution to journalReview article

36 Citations (Scopus)

Abstract

Neurologic injury, in the form of either stroke or more subtle neurocognitive impairment, is a frequent and potentially devastating complication of coronary artery bypass grafting (CABG). The etiology of CABG-associated neurologic injury is likely multifactorial, with the phenomena of cerebral hypoperfusion and embolism being the major contributors. Several perioperative strategies have been developed in an effort to reduce the incidence of CABG-associated neurologic complications. Hypothermic cerebral perfusion, alpha stat acid-base management, and slow patient rewarming have been shown by several investigators to minimize adverse neurologic sequelae associated with the use of cardiopulmonary bypass. Performing CABG without cardiopulmonary bypass (off-pump CABG), meanwhile, has been shown to reduce the risk of perioperative stroke, especially in high-risk patients such as the elderly. Whether off-pump CABG reduces the incidence of less severe neurocognitive impairment has not yet been clearly established and merits further investigation in the form of large, multicenter, randomized trials. Other technical innovations, such as the use of sutureless and clampless aortic anastomotic devices, also may be able to further minimize the neurologic complications associated with CABG.

Original languageEnglish (US)
Pages (from-to)52-62
Number of pages11
JournalSeminars in Thoracic and Cardiovascular Surgery
Volume15
Issue number1
StatePublished - Jan 2003
Externally publishedYes

Fingerprint

Cardiopulmonary Bypass
Coronary Artery Bypass
Nervous System
Off-Pump Coronary Artery Bypass
Nervous System Trauma
Stroke
Intracranial Embolism
Rewarming
Incidence
Multicenter Studies
Perfusion
Research Personnel
Equipment and Supplies
Acids

Keywords

  • Cardiopulmonary bypass
  • Cerebral embolism
  • Coronary artery bypass grafting
  • Neurocognitive dysfunction
  • Stroke

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Scarborough, J. E., White, W., Derilus, F. E., Mathew, J. P., Newman, M. F., & Landolfo, K. P. (2003). Neurologic outcomes after coronary artery bypass grafting with and without cardiopulmonary bypass. Seminars in Thoracic and Cardiovascular Surgery, 15(1), 52-62.

Neurologic outcomes after coronary artery bypass grafting with and without cardiopulmonary bypass. / Scarborough, John E.; White, William; Derilus, Frantz E.; Mathew, Joseph P.; Newman, Mark F.; Landolfo, Kevin P.

In: Seminars in Thoracic and Cardiovascular Surgery, Vol. 15, No. 1, 01.2003, p. 52-62.

Research output: Contribution to journalReview article

Scarborough, JE, White, W, Derilus, FE, Mathew, JP, Newman, MF & Landolfo, KP 2003, 'Neurologic outcomes after coronary artery bypass grafting with and without cardiopulmonary bypass', Seminars in Thoracic and Cardiovascular Surgery, vol. 15, no. 1, pp. 52-62.
Scarborough JE, White W, Derilus FE, Mathew JP, Newman MF, Landolfo KP. Neurologic outcomes after coronary artery bypass grafting with and without cardiopulmonary bypass. Seminars in Thoracic and Cardiovascular Surgery. 2003 Jan;15(1):52-62.
Scarborough, John E. ; White, William ; Derilus, Frantz E. ; Mathew, Joseph P. ; Newman, Mark F. ; Landolfo, Kevin P. / Neurologic outcomes after coronary artery bypass grafting with and without cardiopulmonary bypass. In: Seminars in Thoracic and Cardiovascular Surgery. 2003 ; Vol. 15, No. 1. pp. 52-62.
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