Key result
This review explores the role of panvascular inflammation in perioperative CNS impairment during cardiac surgery and evaluates risk modification strategies to decrease stroke and neurocognitive decline.
Why the study?
What is the role of panvascular inflammation and various risk modification strategies in perioperative CNS outcomes for patients undergoing cardiac surgery?
What is the role of panvascular inflammation and various risk modification strategies in perioperative CNS outcomes for patients undergoing cardiac surgery?
This review highlights the fundamental role of panvascular inflammation in perioperative CNS injury during cardiac surgery and summarizes strategies to mitigate these risks.
May inform trials of inflammation-targeted strategies to reduce perioperative stroke; does not yet support practice changes in cardiac surgery.
In this review, the evidence for inflammatory processes as being of fundamental importance in end-organ dysfunction- specifically stroke and neurocognitive impairment in patients undergoing cardiac surgery-will be reviewed. The risk of central nervous system (CNS) impairment following an off-pump cardiac surgery will be contrasted with that of patients undergoing percutaneous coronary intervention (PCI) or medical management, and the role of progression of underlying cerebrovascular disease and, in particular, panvascular inflammation as an accompaniment to unstable angina with attendant risk of stroke will be explored. In addition, the various roles of preoperative comorbidities, aortic atheroma, and the use of selective avoidance of aortic instrumentation as well as carotid endarterectomy as risk modification strategies will be evaluated. Finally, a summary of recommendations for strategies to decrease risk of perioperative CNS impairment will be presented.
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John M. Murkin (2010) conducted a review in Perioperative CNS impairment in patients undergoing cardiac surgery. Panvascular inflammation and risk modification strategies was evaluated on Perioperative CNS impairment (stroke and neurocognitive impairment). This review explores the role of panvascular inflammation in perioperative CNS impairment during cardiac surgery and evaluates risk modification strategies to decrease stroke and neurocognitive decline.
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