Neurological complications of open heart surgery

AIM: The aim of the present study was to assess neurological sequelae within 30 days of surgical or cardiac catheter interventions in infants and children. METHOD: In this cross-sectional study, we evaluated all patients who developed neurological problems after cardiac interventions either by surgery or by catheter by clinical evaluation, brain imaging, and electrophysiological studies. RESULTS: Among 1200 procedures were performed; 895 (74.6%) were cardiac catheterizations either diagnostic or intervention, 167 (13.9%) were open-heart surgery, and 138 (11.5%) were closed heart surgery. The overall incidence of post-procedure neurological dysfunction in the studied population was 3.4%. The differences between the three groups were statistically significant (p < 0.0001(. In our series, the neurological complications were in the form of disturbed conscious level in 2/41 (4.9%), impaired motor function in 11/41 (26.8%), impaired mental functions in 6/41(14.6%), hyperreflexia in 27/41 (65.9%), and seizures in 38/41 (92.7%). The most common presentation of seizures was in the form of focal fits 21/41 (51.2%), followed by generalized fits in 15/41(36.6%) and then myoclonic fits 2/41 (4.9%). CONCLUSION: Seizures are the most common complication following cardiac interventions in pediatric age and the highest percentage following open heart surgery.

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Posttraumatic Growth following Open-heart Surgery: The Role of Religious Coping and the Underlying Mechanism

PsycEXTRA Dataset ◽

10.1037/e576422013-001 ◽

2013 ◽

Author(s):

Amy Ai

Keyword(s):

Posttraumatic Growth ◽

Religious Coping ◽

Heart Surgery ◽

Open Heart Surgery ◽

Underlying Mechanism ◽

Open Heart

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The Hemostatic Mechanism after Open-Heart Surgery

Thrombosis and Haemostasis ◽

10.1055/s-0038-1646707 ◽

1978 ◽

Vol 39 (02) ◽

pp. 474-487 ◽

Cited By ~ 2

Author(s):

E R Cole ◽

F Bachmann ◽

C A Curry ◽

D Roby

Keyword(s):

Extracorporeal Circulation ◽

Heart Surgery ◽

Polyacrylamide Gel Electrophoresis ◽

Open Heart Surgery ◽

Coagulation System ◽

Open Heart ◽

Time Activity ◽

Post Surgery ◽

Plasma Fractions ◽

The Mean

SummaryA prospective study in 13 patients undergoing open-heart surgery with extracorporeal circulation revealed a marked decrease of the mean one-stage prothrombin time activity from 88% to 54% (p <0.005) but lesser decreases of factors I, II, V, VII and X. This apparent discrepancy was due to the appearance of an inhibitor of the extrinsic coagulation system, termed PEC (Protein after Extracorporeal Circulation). The mean plasma PEC level rose from 0.05 U/ml pre-surgery to 0.65 U/ml post-surgery (p <0.0005), and was accompanied by the appearance of additional proteins as evidenced by disc polyacrylamide gel electrophoresis of plasma fractions (p <0.0005). The observed increases of PEC, appearance of abnormal protein bands and concomitant increases of LDH and SGOT suggest that the release of an inhibitor of the coagulation system (similar or identical to PIVKA) may be due to hypoxic liver damage during extracorporeal circulation.

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Blood Coagulation Studies and Extracorporeal Circulation in Man

Thrombosis and Haemostasis ◽

10.1055/s-0038-1655073 ◽

1967 ◽

Vol 18 (03/04) ◽

pp. 634-646 ◽

Cited By ~ 6

Author(s):

N Thurnherr

Keyword(s):

Blood Coagulation ◽

Extracorporeal Circulation ◽

Blood Clotting ◽

Heart Surgery ◽

Open Heart Surgery ◽

Fibrinolytic System ◽

Open Heart ◽

Clotting Factors ◽

Blood Clotting Factors

SummaryBlood clotting investigations have been executed in 25 patients who have undergone open heart surgery with extracorporeal circulation. A description of alterations in the activity of blood clotting factors, the fibrinolytic system, prothrombin consumption and platelets during several phases of the operation is given.

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Coagulation- and fibrinolysis-alterations in open heart surgery

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-2005-922376 ◽

2005 ◽

Vol 53 (S 3) ◽

Author(s):

U Boeken ◽

P Feindt ◽

J Litmathe ◽

E Gams

Keyword(s):

Heart Surgery ◽

Open Heart Surgery ◽

Open Heart ◽

Coagulation And Fibrinolysis

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Open heart surgery and repair of complex abdominal aortic aneurysms – early and long-term results of a simultaneous approach

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-2007-967411 ◽

2007 ◽

Vol 55 (S 1) ◽

Author(s):

A Rastan ◽

M Luduena ◽

R Battelini ◽

T Walther ◽

J Kempfert ◽

...

Keyword(s):

Heart Surgery ◽

Open Heart Surgery ◽

Abdominal Aortic Aneurysms ◽

Aortic Aneurysms ◽

Long Term Results ◽

Open Heart ◽

Simultaneous Approach ◽

Abdominal Aortic

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Open heart surgery in patients with cold agglutinins: Is the fear justified?

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-2007-967644 ◽

2007 ◽

Vol 55 (S 1) ◽

Author(s):

N Madershahian ◽

T Wittwer ◽

J Strauch ◽

J Wippermann ◽

UFW Franke ◽

...

Keyword(s):

Heart Surgery ◽

Open Heart Surgery ◽

Open Heart ◽

Cold Agglutinins

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Evaluation of Positive Inotropic Drug Effects on Thyroid Hormone Levels after Open Heart Surgery

The Heart Surgery Forum ◽

10.1532/hsf98.20121084 ◽

2015 ◽

Vol 16 (2) ◽

pp. 78

Author(s):

Umit Kervan ◽

Anil Ozen ◽

Utku Unal ◽

Irfan Tasoglu ◽

Mahmut Mustafa Ulas ◽

...

Keyword(s):

Drug Therapy ◽

Thyroid Hormone ◽

Heart Surgery ◽

Open Heart Surgery ◽

Open Heart ◽

Inotropic Drug ◽

Hormone Levels ◽

Inotropic Drugs ◽

Positive Inotropic Drug ◽

Thyroid Hormone Levels

Objective: The aim of this study was to examine the effects of positive inotropic drugs, including adrenaline, dopamine, and dobutamine on thyroid hormone levels following open heart surgery.Methods: We analyzed free thyroid hormones (FT3 and FT4) and thyroid-stimulating hormones (TSH) in 200 consecutive patients undergoing open heart surgery. Patients were divided into 5 groups according to the inotropic drug administration as follows: Group A (n = 46) received dopamine alone; Group B (n = 40), dopamine and dobutamine; Group C (n = 36), dopamine, dobutamine, and adrenaline; Group D (n = 32), adrenaline alone; and Group E (n = 46), placebo. Procedural factors affecting thyroid hormones were recorded and included cardiopulmonary bypass (CPB) time, cross-clamping time, degree of hypothermia, and the duration and doses of positive inotropic drugs. Blood samples for hormone assays were collected before initiation of inotropic drug therapy (baseline) and postoperatively at 24, 72, and 120 hours after drug therapy.Results: FT3, FT4, and TSH levels at baseline were similar in all groups. Although there was a trend showing very slight increases in thyroid hormone levels from baseline to the 24th, 72nd, and 120th postoperative hours after drug therapy, these changes were not significant, and there were also no significant differences between the groups. There was also no significant statistical difference in CPB time, cross-clamping time, degree of hypothermia, and duration and doses of positive inotropic drugs between groups.Conclusion: Although thyroid hormone levels were affected by positive inotropic drug usage after open heart surgery, this effect was not significant and thyroid hormone levels remained within normal ranges.

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