Cognitive dysfunction after cardiac surgery: Strategies for prevention
Pandit JJ., Pigott D.
After cardiac surgery, post-operative stroke and cognitive dysfunction are potential major problems. Currently, the major cause of cerebral dysfunction is thought to be related to embolisation but other factors may be involved as well. There are three broad areas of possible intervention: surgical techniques; management of cardiopulmonary bypass; and management of anaesthesia, including the use of neuroprotective drugs. A randomised trial of off-pump coronary artery bypass grafting (CABG) is awaited. The molecular biology of apolipoprotein Eε4 may provide some answers.