Complications of CABG and CPB

For 1997, in a dataset comprising 161,018 primary CABGs, the overall operative mortality was 2.8%. Major complications included Q-wave myocardial infarction (1.1%), adverse neurological events (5.4%), pulmonary complications (11.2%), acute renal failure (3.1%), and sternal wound infection (1.4%). Stroke was observed in 3.1% of patients and cognitive dysfunction or seizures were observed in 3.0%.

Cardiopulmonary bypass (CPB) carries with it inherent risks. In addition to the risk of microemboli, CPB induces a total body inflammatory response caused by the activation of the complement system due to contact of the blood with the artificial surface of the CPB circuit. All organs are affected to a varying degree, potentially leading to dysfunction and/or damage of the brain, lungs, heart itself, bowel, kidneys, and coagulation system. Nonpulsatile flow is one of the mechanisms which, in combination with the inflammatory response and the release of free radicals, is thought to be responsible for postoperative renal failure.

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