TY - JOUR AU - O. Gogayeva AU - A. Rudenko AU - V. Lazoryshynets PY - 2020/03/22 Y2 - 2024/03/29 TI - Neurological Complications after Coronary Artery Bypass Grafting for High-Risk Patients: Current State of the Problem JF - Ukrainian Journal of Cardiovascular Surgery JA - ujcvs VL - IS - 2 (39) SE - ISCHEMIC HEART DISEASE DO - 10.30702/ujcvs/20.3905/022015-017 UR - https://cvs.org.ua/index.php/ujcvs/article/view/345 AB - Neurological disorders are the most serious and debilitating complications of the postoperative period in cardiac surgery. The main clinical manifestations of cerebral dysfunction are as follows: stroke, decreased cognitive function, encephalopathy and depressive disorder.The aim. To perform a literature review of neurological complications after coronary artery bypass grafting (CABG) in high-risk patients.Results. The main neurological complications after CABG in high-risk patients were considered. The main pathophysiological mechanisms of development of cerebral circulation disorders in the form of macro- and microembolization, hypoperfusion secondary to hypotension and systemic inflammatory response have been determined. According to the literature, the incidence of stroke in the postoperative period is 1.5–6%, and it increases in the elderly. It’s important to perform carotid arteries ultrasound before CABG. According to the literature, carotid stenosis greater than 60% is found, depending on the age group, in 7–12% of patients. There is an ongoing debate around the world regarding the method and time of carotid atherosclerosis surgery (before revascularization, during or after CABG). Newman and co-authors have shown that in 5 years after myocardial revascularization, 41% of patients have a decrease in cognitive function, and it is lower than it was before surgery. Opponents of on-pump CABG have hypothesized the occurrence of Alzheimer’s disease after surgery with extracorporeal circulation, but authors from Mayo Clinic have investigated this question and refuted this theory; Canadian researchers have even proved the positive effect of revascularization on prevention of Alzheimer’s disease. The main strate­ gy for the prevention of cerebral complications is an individual approach for each high-risk patient. ER -