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Ann Thorac Surg 1983;36:675-679
© 1983 The Society of Thoracic Surgeons

Articles

Mechanism and Frequency of Brachial Plexus Injury in Open-Heart Surgery: A Prospective Analysis

Maurice R. Hanson, M.D.*, Anthony C. Breuer, M.D., Anthony J. Furlan, M.D., Richard J. Lederman, M.D., Ph.D., Asa J. Wilbourn, M.D., Delos M. Cosgrove, M.D., Floyd D. Loop, M.D., F. George Estafanous, M.D.

From the Departments of Neurology, Cardiothoracic Surgery, and Cardiothoracic Anesthesiology, The Cleveland Clinic Foundation, Cleveland, OH

Accepted for publication February 10, 1983.

* Address reprint requests to Dr. Hanson, Department of Neurology, The Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH 44106

A computer-assisted prospective analysis of 531 patients undergoing open-heart operations revealed that 26 patients (5%) sustained brachial plexus injury. In 22 of the 26 patients (85%), the lesion involved the lower trunk or C8-T1 nerve roots. Electromyograms confirmed the clinical impression in 13 patients. In 19 of the 26 patients (73%), the side on which the plexus lesion was found correlated with the side of internal jugular vein cannulation. Because of the anatomical proximity of the lower trunk to the internal jugular vein and the preponderance of lower trunk lesions, we postulate that traumatic cannulation may be a major mechanism of plexus injury. Thus, the resulting syndrome of pain, dysesthesias, and hand weakness may sometimes be preventable.




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