Subclinical Cerebral Complications After Coronary Artery Bypass Grafting

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Abstract
CORONARY ARTERY bypass grafting (CABG) has been performed for more than 30 years and is now the most common major surgical procedure in the United States. Annually, more than 800000 patients throughout the world undergo myocardial revascularization procedures.1 Coronary artery bypass grafting effectively relieves angina, may prolong life, and has, at present, a relatively low mortality rate, factors that have encouraged its use for more marginal indications. Therefore, morbidity is now an important factor in the assessment of the risk-benefit ratio.2 Of all the adverse outcomes associated with CABG, neurologic complications form an important proportion.3 Because of the huge number of operations performed, reduction of both the severe and milder cerebral complications is a continuing challenge for surgical practice, perfusion technique, and patient surveillance methods. Several prospective studies have assessed the incidence of neurologic complications after CABG and have evaluated their risk factors.1,4,5 The incidence of serious focal complications, such as fatal or nonfatal permanent stroke or transient ischemic attacks, has been reported to be 3.1% to 5.2%.1,5,6 Moderate complications, such as clinically obvious deterioration in intellectual function or seizures, have been detected in an additional 3.0% of cases.1