[Neurological complications of cardiac surgery].

Rev Esp Cardiol. 2005;58(9):1003-6 1003 Despite the advances in surgical techniques, cardiopulmonary bypass circuits and the medical treatment of patients subjected to cardiac surgery, perioperative complications involving the nervous system continue to develop and the underlying mechanisms are sometimes poorly understood. Neurological complications (NC) in these patients can affect the brain, spinal cord and peripheral nerves. However, the involvement of the central nervous system, and cerebrovascular involvement in particular, is the most common adverse event. It is associated with high rates of morbidity and mortality, longer hospital stays and greater utilization of health care resources, in addition to the severe financial and social distress that these complications bring upon the patients and their families. The incidence of NC following cardiac surgery depends on the methodology employed for its diagnosis, on the terminology utilized and on the application of a prospective or retrospective approach in its evaluation. In a recent report assessing the type of surgery performed,1 NC (transient ischemic attack or stroke) presented in 1.7% of the patients undergoing coronary revascularization, in 3.6% of those having single valve replacement, in 3.3% of those subjected to both procedures and in 6.7% of those undergoing multiple valve replacement. These values agree with those reported for previous series, which indicated a greater number of NC after valve replacement than after coronary revascularization. In fact, in some series of patients subjected to valve replacement, an incidence of stroke of up to 16% has been observed. ED I TO R I A L S