| 관상동맥우회술의 중추신경계 합병증 |
| 배희준, 윤병우, 강동화, 김성훈, 홍근식, 김기봉*, 노재규 |
| 서울대학교 의과대학 신경과학교실, 흉부외과학교실* |
| CENTRAL NERVOUS SYSTEM COMPLICATIONS OF CORONARY ARTERY BYPASS GRAFT SURGERY |
| Hee-Joon Bae, Byung-Woo Yoon, Dong-Wha Kang, Sung-Hun Kim, Keun-Sik Hong, Ki-Bong Kim*,
Jae-Kyu Roh |
| Department of Neurology & Cardiothoracic Surgery*, College of Medicine,
Seoul National University |
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| Abstract |
Background: Coronary artery bypass graft (CABG) surgery is performed more frequently than before in Korea. Central nervous system (CNS) complications are often the major prognostic determinants following the surgery. We carried out a prospective study to clarify the incidence and risk factors of neurologic complications after CABG surgery.
Methods: A consecutive series of 150 patients undergoing 152 CABG operations from March 1995 to July 1997 by one cardiac surgeon was evaluated by a team of neurologists before and after the surgery. The patients received extensive preoperative examinations including the evaluation of intracranial & extracranial cerebral artery disease.
Results: In 44 operations (28.9%), we detected various neurologic complications, including encephalopathy (36 operations, 23.7%), cerebral infarction (5 operations, 3.3%), and seizure (7 operations, 4.6%). Eight patients died postoperatively including one due to neurologic complication. On univariate analysis, age, degree of intracranial artery disease (ICAD), duration of bypass time, hypotension index, duration of ventricular assistant device (VAD), intraoperative event, intra- or postoperative arrhythmia, reoperation, and postoperative bleeding were statistically significant risk factors of CNS complications (p< 0.05). After multivariate analysis, however, age alone remained significant (p=0.02). The degree of ICAD showed marginal significance (p=0.06).
Conclusions: The incidence of CNS complication in the patients undergoing CABG surgery was 28.9%. Our results showed that age was an independent risk factor of CNS complications. And the possibility of ICAD as a risk factor was suggested. Further study with a large number of patients would be necessary to prove the above suggestion.
Key words: CNS complications, CABG (coronary artery bypass graft), surgery, intracranial artery disease, extracranial artery disease |
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