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The Annals of Thoracic Surgery, Vol 41, 293-296, Copyright © 1986 by The Society of Thoracic Surgeons
RW Landymore, CE Kinley, DA Murphy and JA Sullivan
Neurological injury following myocardial revascularization may result from
embolization of atheromatous debris from the diseased ascending thoracic
aorta. Eight patients with calcified aortas who underwent elective
myocardial revascularization suffered major strokes as a result of
manipulation and clamping of the diseased ascending aorta during a 30-month
period before July, 1981. computerized axial tomography scans demonstrated
multiple cerebral infarctions in each patient. Six patients never regained
consciousness and died as a result of neurological injury; 2 patients
regained consciousness but were left with major neurological deficits.
Later, 21 patients with calcific aortic degenerative disease underwent a
specific operative protocol, designed to prevent neurological injury during
elective myocardial revascularization. All 21 patients recovered without
neurological complications. Specific attention to operative technique
allowed this difficult group of patients with incapacitating angina and
calcific degenerative aortic disease to have the benefit of coronary
bypass.
ARTICLES
Prevention of neurological injury during myocardial revascularization in patients with calcific degenerative aortic disease
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