Prevention of neurological damage during open-heart surgery.

A previous study of neurological damage related to open-heart surgery suggested that the onset of cardiopulmonary bypass is a time of particular hazard, and there is evidence that both microemboli from the extracorporeal circulation and inadequate cerebral perfusion may be contributory factors. Measures to eliminate or minimize these hazards have been introduced, and a clinical survey has been undertaken to evaluate their efficacy. There has been a very highly significant decrease in the incidence of neurological damage as judged by comparison with the results of a similar survey carried out before these measures were introduced. In spite of limitations imposed by differences in workload, perfusion techniques, and methods of data collection, it is concluded that the prophylactic measures have been responsible for the reduction in the incidence of neurological damage.