Bypass surgery some risk to the brain
December 18, 1996
Web posted at: 11:30 p.m. EST
(CNN) -- Though heart bypass surgery can be lifesaving, a new medical study shows the operation may pose greater risks to the brain than previously thought.
Consider Clifford Wood, who is still trying to recover from a debilitating stroke. Doctors believe his stroke was caused by the heart bypass surgery that helped save his life earlier this year.
Doctors have long known that some heart bypass patients suffer strokes after surgery, while others wind up having trouble thinking clearly or remembering things.
But a major new medical study suggests the risks from bypass surgery to the brain are as much as 10 times greater than previously realized.
In a nationwide study, detailed in the latest New England Journal of Medicine, researchers were surprised at the rate of significant brain injury following bypass surgery.
More than six percent of patients who underwent bypass surgery -- 25,000 patients in the United States and 50,000 worldwide -- had to also undergo brain surgery afterwards, said Dr. Dennis Mangano of the San Francisco VA Medical Center.
Doctors have been aware of the problem for a while, although the recent study underscores its seriousness. Surgeons at the Bowman Gray School of Medicine in Winston-Salem, North Carolina, say they've reduced by 50 percent the number of stroke and brain-complications following bypass surgery.
They -- and other doctors -- have done it by changing the way they handle the blocked coronary arteries they're "bypassing."
New monitoring techniques help them further reduce the risk of brain damage. The idea is to spot tiny particles of air and plaque that can be dislodged during bypass surgery.
These particles can block blood flow to the brain and lead to death, a crippling stroke or mental impairment.
The risk of brain injury increases dramatically with age, the new study shows.
"If a patient is 45 and relatively healthy, the risk of these complications is low, less than one percent," Mangano said.
But for a 75-year-old suffering with more than heart disease, the risk of brain injury following bypass surgery can be more than 10 percent.
Doctors emphasize this study is not intended to deter people from bypass surgery. Rather, they hope it helps them and their doctors to better evaluate the risks.
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