Intraoperative Embolization and Cognitive Decline After Cardiac Surgery: A Systematic Review

Seminars in Cardiothoracic and Vascular Anesthesia
Nikil PatelEmma M L Chung

Abstract

Since the advent of cardiac surgery, complications have existed in many forms. Recent work has focused on the safety of current cardiac surgery with particular emphasis on cognitive outcomes. Cardiopulmonary bypass has improved the safety of operative practice; however, increasing concern surrounds the measurable and immeasurable impact embolization has on the brain. New ischemic lesions have been associated with distant emboli, which intraoperatively enter the cardiovascular system. This has prompted better characterization of the nature of emboli manifesting as cognitive impairment postoperatively. The difficulty in attributing causation relates to the subclinical damage that does not necessarily manifest as clinical stroke. Transcranial Doppler has become an important tool in documenting cerebral emboli during surgery. The purpose of this systematic review is to focus on the current literature to improve our understanding of the impact embolization has on the brain. We also aim to investigate which cardiac interventions hold the greatest burden of embolic load and how previous literature has investigated the impact of emboli on cognition by monitoring emboli during specific cardiac interventions. Significant intraoperative f...Continue Reading

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Citations

Jul 21, 2016·Seminars in Cardiothoracic and Vascular Anesthesia·Miklos D Kertai
Dec 17, 2016·Anesthesia and Analgesia·Brian E Schmidt, Arthur M Lam
Oct 7, 2017·European Journal of Anaesthesiology·Sandro GlumacNenad Karanovic
Nov 22, 2017·Journal of the American Geriatrics Society·Maisha M KhanKrista L Lanctôt
Jul 11, 2020·World Journal for Pediatric & Congenital Heart Surgery·Max H TwedtGregory R Bashford
Aug 24, 2021·Journal of Cardiothoracic and Vascular Anesthesia·Benjamin MilneGudrun Kunst

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BETA
coronary artery bypass

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