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Ann Thorac Surg 1999;68:1467
© 1999 The Society of Thoracic Surgeons

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Supplement: Outcomes ’99: Scientific Abstracts

Neurological complications after adult cardiac surgery: role of type of pump and CPB variables

^a Department of Cardiac Surgery, University of Milano, Milan, Italy

Background: The aim of this study was to determine if the type of pump or other cardiopulmonary bypass (CPB) variables can affect the neurological outcome after adult cardiac operation.

Methods: During the period January 1994 to July 1998, 2773 adult patients underwent coronary and/or valve surgery at our hospital. All patients underwent surgery with the use of membrane oxygenator, moderate (30°C) hypothermia, and alpha-stat acid base management. Of these, 1765 (63.6%) underwent surgery with the use of a centrifugal pump (Biomedicus BioPump, Medtronic, Inc, Eden Prarie, MN), while 1008 (36.4%) were operated with a roller pump (Stockert CAPS HLM, Stockert Inc). Demographics, preoperative and intraoperative variables, as well as CPB variables were analyzed for their possible influence on the neurological outcome with univariate and multivariable analyses.

Results: Permanent neurological deficit and coma occurred in 52 (1.9%), and 33 (1.2%) patients, respectively. There were no statistically significant differences between patients who underwent surgery with the use of the centrifugal or roller pumps (1.6 vs 2.3% for permanent neurological deficit, 1.0% vs 1.6%, for coma). Logistic regression analysis identified the following predictors for an adverse neurological outcome after adult cardiac surgery.

Permanent Neurological Deficit p OR Coma p OR Shock at anesthesia induction 0.001 32.61 CPB time < 0.001 1.007 Age 0.007 1.05 Previous vascular surgery 0.001 5.61 Lowest rectal temperature 0.016 0.86 Preoperative weight 0.002 0.95 Previous transient ischemic attack 0.021 2.42 Preoperative creatinine level 0.014 1.39 Preoperative creatinine level 0.038 1.41 Lowest rectal temperature 0.004 0.83 CPB time 0.046 1.003 Age 0.011 1.07 Previous Reversible Ischemic Neurological Deficit 0.028 6.75

Conclusions: The type of the pump (centrifugal versus roller) did not affect the neurological outcomes of patients undergoing adult coronary and/or valve surgery; on the other hand, longer CPB times and lower degrees of hypothermia increased the neurological risk.

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Alamanni, F. Articles by Biglioli, P. Search for Related Content PubMed Articles by Alamanni, F. Articles by Biglioli, P.