Prevention of Neurological Complications after Cardiac Surgery

Neurological complications after cardiac surgery are potentially debilitating and life -threatening. They range from discrete changes detectable only with neuroimaging methods through mild and transient cognitive and motor impairments to severe focal and generalized brain damage with coma and persistent vegetative state. Their occurrence depends on the preoperative condition of the patient and his comorbidity, such as the presence of carotid stenosis, atrial fibrillation, calcinosis of the ascending aorta, as well as on the type of planned surgical intervention, as in open surgery conditions are created for the occurrence of air embolism. The decrease in the percentage of patients with neurological damage is related both to the preoperative diagnosis of the risk factors and to the application of intraoperative monitoring and surgical techniques reducing the influence of the factors leading to these complications. Surgical techniques are associated with manipulation of the aorta, shortening the time of cardiopulmonary bypass, thorough deaeration of the cardiac cavities. Preventing the occurrence of neurological complications requires the efforts of the entire team involved in the operative intervention. Despite all modern methods of prevention of these complications, they cannot be completely eliminated and play a leading role in perioperative disability and mortality.