Neurological Complications of Cardiopulmonary Bypass


  • Mahmut Padak



Cardiopulmonary Bypass, Neurological Complications, Cardiac Surgery


Neurological complications associated with heart surgery and cardiopulmonary bypass are common and can cause serious consequences in some cases. In this review study, we aimed to provide information about the complications that may be encountered after surgery in patients who underwent cardiac surgery with the cardiopulmonary bypass method.


Gilbey T, Milne B, de Somer F, Kunst G. Neurologic complications after cardiopulmonary bypass- A narrative review. Perfusion. 2023;38(8):1545-1559.

Oi K, Arai H. Stroke associated with coronary artery bypass grafting. Gen Thorac Cardiovasc Surg 2015; 63: 487–495.

Dacey LJ, Likosky DS, Leavitt BJ, et al. Perioperative stroke and long-term survival after coronary bypass graft surgery. Ann Thorac Surg 2005; 79: 532–536.

Roach GW, Kanchuger M, Mangano CM, et al. Adverse cerebral outcomes after coronary bypass surgery. Multicenter Study of Perioperative Ischemia Research Group and the Ischemia Research and Education Foundation Investigators. N Engl J Med. 1996; 335: 1857–1863.

Abu-Omar Y, Balacumaraswami L, Pigott DW, et al. Solid and gaseous cerebral microembolization during off pump, on-pump, and open cardiac surgery procedures. J Thorac Cardiovasc Surg 2004; 127: 1759–1765.

Eyjolfsson A, Dencker M, Bronden B, et al. Lipid emboli ´ distribution in cardiac surgery is dependent on the state of emulsification. Scand Cardiovasc J. 2012; 46: 51–56.

Kincaid EH, Jones TJ, Stump DA, et al. Processing scavenged blood with a cell saver reduces cerebral lipid microembolization. Ann Thorac Surg. 2000; 70: 1296–1300.

Banbury MK, Kouchoukos NT, Allen KB, et al. Emboli capture using the Embol-X intraaortic filter in cardiac surgery: a multicentered randomized trial of 1, 289 patients. Ann Thorac Surg. 2003; 76(2): 508–515.

Likosky DS, Marrin CA, Caplan LR, et al. Determination of etiologic mechanisms of strokes secondary to coronary artery bypass graft surgery. Stroke. 2003; 34: 2830–2834.

O’Brien SM, Feng L, He X, et al. The society of thoracic surgeons 2018 adult cardiac surgery risk models: Part 2- statistical methods and results. Ann Thorac Surg. 2018; 105: 1419–1428.

Wolman RL, Nussmeier NA, Aggarwal A, et al. Cerebral injury after cardiac surgery: identification of a group at extraordinary risk. Multicenter Study of Perioperative Ischemia Research Group (McSPI) and the Ischemia Research Education Foundation (IREF) Investigators. Stroke. 1999; 30: 514–522.

Merie C, Køber L, Olsen PS, et al. Risk of stroke after ´ coronary artery bypass grafting: effect of age and comorbidities. Stroke. 2012; 43: 38–43.

Selnes OA, Gottesman RF, Grega MA, et al. Cognitive and neurologic outcomes after coronary-artery bypass surgery. N Engl J Med. 2012; 366: 250–257.

Hogue CW, Murphy SF, Schechtman KB, et al. Risk factors for early or delayed stroke after cardiac surgery. Circulation. 1999; 100(6): 642–647.

Fan C, Zhang Q, Wang A, et al. No association between postmenopausal time and the prevalence of newly discovered asymptomatic intracranial atherosclerotic stenosis: the APAC study. J Clin Neurosci. 2020; 78: 259–263.

Naylor AR, Bown MJ. Stroke after cardiac surgery and its association with asymptomatic carotid disease: an updated systematic review and meta-analysis. Eur J Vasc Endovasc Surg. 2011; 41: 607–624.

Biancari F, Santini F, Tauriainen T, et al. Epiaortic ultrasound to prevent stroke in coronary artery bypass grafting. Ann Thorac Surg. 2020; 109: 294–301.

Ferraris VA, Brown JR, Despotis GJ, et al. update to the Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologists blood conservation clinical practice guidelines. Ann Thorac Surg. 2011; 91: 944–982.

Kunst G, Milojevic M, Boer C, et al. EACTS/ EACTA/EBCP guidelines on cardiopulmonary bypass in adult cardiac surgery. Br J Anaesth. 2019; 123: 713–757.

Vedel AG, Holmgaard F, Rasmussen LS, et al. Hightarget versus low-target blood pressure management during cardiopulmonary bypass to prevent cerebral injury in cardiac surgery patients: a randomized controlled trial. Circulation. 2018; 137: 1770–1780.

Preventza O, Coselli JS, Akvan S, et al. The impact of temperature in aortic arch surgery patients receiving antegrade cerebral perfusion for >30 minutes: How relevant is it really? J Thorac Cardiovasc Surg. 2017; 153: 767–776.

Pearl JM, Thomas DW, Grist G, et al. Hyperoxia for management of acid-base status during deep hypothermia with circulatory arrest. Ann Thorac Surg. 2000; 70: 751–755.

Xu F, Uh J, Brier MR, et al. The influence of carbon dioxide on brain activity and metabolism in conscious humans. J Cereb Blood Flow Metab. 2011; 31(1): 58–67.

Evered L, Silbert B, Knopman DS, et al. Recommendations for the nomenclature of cognitive change associated with anaesthesia and surgery-2018. Br J Anaesth. 2018; 121: 1005–1012.

Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA. American Psychiatric Association, 2013.

Pataraia E, Jung R, Aull-Watschinger S, et al. Seizures after adult cardiac surgery and interventional cardiac procedures. J Cardiothorac Vasc Anesth. 2018; 32: 2323–2329.

Gofton TE, Chu MW, Norton L, et al. A prospective observational study of seizures after cardiac surgery using continuous EEG monitoring. Neurocrit Care. 2014; 21: 220–227.

Lecker I, Wang DS, Whissell PD, et al. Tranexamic acidassociated seizures: causes and treatment. Ann Neurol. 2016; 79: 18–26.

Cascella M, Bimonte S, Di Napoli R. Delayed emergence from anesthesia: what we know and how we act. Local Reg Anesth. 2020; 13: 195–206.

Thomas E, Martin F, Pollard B. Delayed recovery of consciousness after general anaesthesia. BJA Education. 2020; 20(5): 173–179.

Blauth CI, Arnold JV, Schulenberg WE, et al. Cerebral microembolism during cardiopulmonary bypass. Retinal microvascular studies in vivo with fluorescein angiography. J Thorac Cardiovasc Surg. 1988; 95: 668–676

Shaw PJ, Bates D, Cartlidge N, et al. Neuroophthalmological complications of coronary artery bypass graft surgery. Acta Neurol Scand. 1987; 76: 1–7.

Welch MB, Brummett CM, Welch TD, et al. Perioperative peripheral nerve injuries: a retrospective study of 380, 680 cases during a 10-year period at a single institution. Anesthesiology. 2009; 111: 490–497.

Sharma AD, Parmley CL, Sreeram G, et al. Peripheral nerve injuries during cardiac surgery: risk factors, diagnosis, prognosis, and prevention. Anesth Analg. 2000; 91: 1358–1369.



How to Cite

Padak, M. (2023). Neurological Complications of Cardiopulmonary Bypass . MEHES JOURNAL, 1(1), 34–42.



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