| 개심술의 중추신경계 합병증에 대한 연구 |
| 노재규, 홍근식, 윤병우 |
| 서울대학교 신경과 |
| CNS Complications of Open heart Surgery |
| Jae Kyu Roh, M.D., Keun Sik Hong, M.D., Byung Woo Yoon, M.D. |
| Department of Neurology, College of Medicine, Seoul National University Hospital |
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| Abstract |
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Objective. To define the incidence, the prognosis, and the risk factors of neurologic complications of open heart surgery.
Background. Open heart surgery poses many hemodynamic, embolic, and metabolic
threats to the brain with multiple factors relating to neurologic complications. Despite
the progress in surgical technique, neurologic complications remain major causes of
morbidity and occasional mortality.
Methods. Data were obtained from the charts of 297 patients submitted to open heart
surgery at SNUH in 1993. We analysed the risk factors for CNS complications and
identified the incidence, the type, and the results of the complications.
Results. Among 297 patients, CNS complications occurred in 34 patients(11.4%). The
incidences of each complication were as follows. ; 6 anoxic encephalopathies(17.7%), 12
encephalopathies of uncertain etiology(35.3%), 7 seizures (20.6%), 6 TIAs or.
Infarctions(17.7%), and 3 other complications(8.8%). Of the 34 patients, there were 6
deaths (17.7%), 1 vegetative state(2.9%), 1 major neurologic deficit(2.9%), 3 minor
neurologic deficits(8.8%), and full recovery in 23 patients(67.7%). The risk factors such
as age, presence of thrombi, type of operation, duration of bypass, duration of aortic
clamping time, use of total circulatory arrest, re-operation, and use of ventricular assist
device were statistically significant.
Conclusion. The CNS complications of open heart surgery are infrequent but still
remain important causes of morbidity and mortality. Evaluating the risk factors could
be of help to prevent the CNS complications. |
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