Characteristics , incidence , and pathomechanisms of neurological damage during cardiac surgery

Modern-day cardiac surgery, made possible by the advent of cardiopulmonary bypass (CPB) almost six decades ago, continues to be challenged by the risk of neurologic injury. While catastrophic injury was common in the early days of CPB, advances in perfusion, anesthetic and surgical techniques now allow the vast majority of patients to undergo surgery without major morbidity or mortality. However, variable degrees of cerebral injury (ranging in severity from the most subtle to the most severe) still occur. With over 1,000,000 patients worldwide undergoing various cardiac operations annually, understanding the incidence, significance and etiology with the subsequent development of neuroprotective strategies is of paramount importance.