The study was done to review cases of patients with neurologic complications after open heart surgery. In children, complications of cardiac surgery are one of the major sources of neurodevelopmental sequelae of congenital heart disease. In the Philippine Heart Center, post operative neurologic complications after open heart surgery have been noted.
The records of patients under 18 years old with neurologic complications after open heart surgery from January 1993 to June 1995 were analyzed. Patients were divided into Group I (congenital, cyanotic), Group II (congenital, acyanotic), and Group III (acquired). The demographic data, clinical characteristics, and variables during cardiopulmonary bypass (CBP) were recorded and statistical analysis was done.
Out of the 306 patients who underwent open heart surgery, 12 patients developed neurologic complications postoperatively. In Group I, 3 patients underwent Tetralogy of Fallot (TOF) correction and 2 patients underwent pulmonary valvotomy. In Group II, 2 patients underwent ventricular septal defect (VSD) closure and 2 underwent patent ductus arteriosus (PDA) and accessory pathway (AP) window with VSD closure, respectively. In Group III, 2 patients underwent mitral valve annuloplasty and another patient underwent correction of mitral and aortic valve replacement. Among the variables studied, there was significant difference with regards to the ischemic time and mean flow rate between the 3 groups (p value 0.05). Neurologic complication noted in all the patients was seizure which developed 24-72 hours postoperatively. Computed tomography (CT) scan revealed infarct, subarachnoid and subdural hemorrhages, subdural effusion, and cerebral edema. Four patients died post-operatively which were mainly secondary to the neurologic complications.
This study showed significant differences with regards to the ischemic time and mean flow rate during CPB in the development of neurologic complications in patients undergoing open heart surgery.