Cerebral Dysfunction in Elective Coronary Surgery

In the sixties and early seventies several authors reported neurological complications following open-heart surgery. A primary matter of discussion was valid preoperative investigation aimed at preventing neurological complications among the increasing number of patients undergoing elective coronary artery bypass grafting (CABG). Controversy exists as to whether patients with asymptomatic carotid bruits have an increased risk of perioperative stroke at the time of cardiac surgery, especially when prolonged hypotension occurs. Moreover, perioperative strokes often occur in patients who were not suspected of having carotid disease. Furthermore, significant carotid occlusive disease may be present without signs or symptoms, and thus remain undiagnosed.