Highlights the importance of multimodal brain protection strategies, including imaging-guided surgical modifications and temperature optimization, to reduce neurological complications in adult cardiac surgery.
Supports multimodal neuroprotection strategies in cardiac surgery; hypothesis-generating and requires randomized confirmation.
Despite remarkable progress in surgical, cardiopulmonary bypass and anaesthetic techniques during the last three decades, brain damage remains an important complication of adult cardiac surgery. Effective brain protection strategies are already implemented today, but ongoing research is needed to meet the challenges faced in operating on increasingly old and disabled patients. The incidence of brain injury may be reduced by modifying the surgical procedure according to carotid duplex scanning and epiaortic echocardiography, by using techniques to reduce microembolization during cardiopulmonary bypass and by optimizing patient temperature during and after surgery. Increased knowledge will aid in choosing the best procedure or combination of procedures in each case to ensure that risks do not outweigh benefits.
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Ahonen et al. (2003) studied this question.
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