Neurological damage related to open-heart surgery. A clinical survey.

A survey has been carried out on all cases submitted to open-heart surgery at one hospital during 1970 to determine which operative features were associated with the occurrence of neurological damage. Four hundred and seventeen subjects survived the operative period. Neurological dysfunction, defined as impairment of consciousness, voluntary movement or vision, apparent within three days of operation, was noted in 80 patients (19·2%). Twenty-one of these 80 patients died in the postoperative period, neurological damage contributing to the fatal outcome in 11 cases. The remaining 59 patients survived to leave hospital but 17 were left with some residual neurological disability. A number of features were found to be positively correlated with the development of neurological damage when considered alone, but multiple regression analysis revealed that only three factors were significantly associated, independent of all other variables. These factors were age, duration of perfusion, and a history of previous neurological disorder. The use of a Temptrol oxygenator was associated with a lower incidence of neurological dysfunction to a degree which was probably significant (p<0·02). The small number of patients perfused with the Temptrol oxygenator (30 cases) reduces the clinical importance of this finding.