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Ann Thorac Surg 1997;63:322-323
© 1997 The Society of Thoracic Surgeons

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Editorial

Toward a New Frontier in Cardiac Surgery

Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina

The first 20% of the full text of this article appears below.

Cardiac surgery has made enormous progress over the past quarter century. Great progress has been made in protection of the heart, and the new frontier is protecting other organs at risk during cardiac operations. Acute alterations in cerebral function after coronary artery bypass grafting is arguably the most important and an increasingly challenging problem primarily because of the older age of patients and their concurrent diseases. Patients undergoing myocardial vascularization procedures, now exceeding 800,000 annually throughout the world, are particularly prone to stroke, encephalopathy, and cognitive dysfunction. Cerebral dysfunction is often attributed to significant atherosclerotic disease subject to hemodynamic fluctuations, cerebral embolization, or a combination of the two. The increasing proportion of perioperative morbidity and mortality that brain injury represents [1–3] has been only partially addressed. Two reports in this issue of The Annals from McKhann and colleagues [4, 5] represent an attempt to more accurately stratify the incidence and persistence of cognitive dysfunction after bypass, as well as determine predictors of stroke . . . [Full Text of this Article]

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Ann. Thorac. Surg. 1997 63: 510-515. [Abstract] [Full Text]

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