Case 72 - Neurologiccomplications following cardiothoracic surgery

Summary

Perioperative neurologic disturbances are a major cause of morbidity and mortality in the cardiac surgery population and numerous methods and techniques have been developed to help minimize these occurrences. This chapter presents a case study of a 34-year-old male with ascending aortic aneurysm and fungal endocarditis. Candida albicans was cultured from the graft material and the patient was placed on appropriate antibiotic therapy. The patient required tracheostomy for respiratory insufficiency, but was eventually weaned from ventilatory support. Since patient required surgery on the aortic arch, interruption of brain perfusion with circulatory arrest was necessary. Hypothermia is used as a technique for global cerebral protection during circulatory arrest. Near infrared spectroscopy (NIRS) is often employed during circulatory arrest to allow assessment of regional oxygen saturation. Since this technology is highly regional in nature, it is speculative to use the data to assess global cerebral oxygenation.