Cerebral Disorders after Open-Heart Operations

Sid Gilman

doi:10.1056/nejm196503112721001

March 11, 1965New England Journal of Medicine

Cerebral Disorders after Open-Heart Operations

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Key Points

Identify the primary mechanisms and surgical factors contributing to central nervous system damage during open-heart surgery supported by extracorporeal circulation.
Evaluated operative hazards associated with extracorporeal pump oxygenator use and hypothermia protocols.
Analyzed procedural sources of microembolism, including air entrapment in the left ventricle and antifoam silicone release from bypass equipment.
Identified persistent arterial air embolism secondary to termination of bypass and faulty coronary-suction devices as a leading cause of cerebral injury.
Observed that protective hypothermia is insufficient to prevent neurological impairment caused by particulate silicone and gaseous microemboli.

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Implication

Clinical review reveals neurological injury mechanisms during open-heart surgery with extracorporeal oxygenators, highlighting persistent risks from air and particulate emboli.

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Sid Gilman (1965) studied this question.

synapsesocial.com/papers/6a0dea329a2918c675a50b23 https://doi.org/10.1056/nejm196503112721001

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Cerebral Disorders after Open-Heart Operations

Key Points

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Implication

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Cerebral Disorders after Open-Heart Operations

Key Points

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Implication

Discussion

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