HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Vahl, C. F. Articles by Struck, E. Search for Related Content PubMed PubMed Citation Articles by Vahl, C. F. Articles by Struck, E.

The Journal of Thoracic and Cardiovascular Surgery, Vol 102, 724-729, Copyright © 1991 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Brachial plexus injury after cardiac surgery. The role of internal mammary artery preparation: a prospective study on 1000 consecutive patients

CF Vahl, I Carl, H Muller-Vahl and E Struck
Department of Cardiac Surgery, Zentralklinikum Augsburg, Germany.

Brachial plexus injury is a typical complication after median sternotomy. A prospective study was performed on 1000 consecutive patients to determine whether preventive actions, including lower position and least possible opening of the sternal retractor, help to reduce the complication rate. Twenty-seven patients were observed with postoperative brachial plexus injury. Nerve conduction measurements and electromyography were performed. Patients without preparation of the internal mammary artery had a complication rate of less than 1%, whereas the complication rate of those patients with preparation of the internal mammary artery was as high as 10.6%. The main symptoms were continuous pain and motor and sensory disturbances. Most frequent were lesions corresponding to the roots C8-T1. Six patients had Horner's syndrome; three had ptosis only with no other signs of Horner's syndrome. Symptoms persisted in eight patients more than 3 months after the operation, and one patient still had intractable pain. Increasing use of internal mammary artery grafts in coronary artery bypass demands measures to protect the brachial plexus.

This article has been cited by other articles:

				Z. I. Khalpey, R. B. Ganim, and J. D. Rawn Postoperative Care of Cardiac Surgery Patients Card. Surg. Adult, January 1, 2008; 3(2008): 465 - 486. [Full Text]

				S. J. Durham and J. P. Gold Late Complications of Cardiac Surgery Card. Surg. Adult, January 1, 2008; 3(2008): 535 - 548. [Full Text]

				Y. Unlu, Y. Velioglu, H. Kocak, N. Becit, and M. Ceviz Brachial plexus injury following median sternotomy Interactive CardioVascular and Thoracic Surgery, April 1, 2007; 6(2): 235 - 237. [Abstract] [Full Text] [PDF]

				H. P. Grocott, J. A. Clark, H. M. Homi, and A. Sharma "Other" Neurologic Complications After Cardiac Surgery Seminars in Cardiothoracic and Vascular Anesthesia, September 1, 2004; 8(3): 213 - 226. [Abstract] [PDF]

				M. M. Stecker Evoked Potentials during Cardiac and Major Vascular Operations Seminars in Cardiothoracic and Vascular Anesthesia, June 1, 2004; 8(2): 101 - 111. [Abstract] [PDF]

				A Y Chong, C E Clarke, W R Dimitri, and G Y H Lip Brachial plexus injury as an unusual complication of coronary artery bypass graft surgery Postgrad. Med. J., February 1, 2003; 79(928): 84 - 86. [Abstract] [Full Text] [PDF]

				Y. J. Woo and T. J. Gardner Myocardial Revascularization with Cardiopulmonary Bypass Card. Surg. Adult, January 1, 2003; 2(2003): 581 - 607. [Full Text]

				A. D. Sharma, C. L. Parmley, G. Sreeram, and H. P. Grocott Peripheral Nerve Injuries During Cardiac Surgery: Risk Factors, Diagnosis, Prognosis, and Prevention Anesth. Analg., December 1, 2000; 91(6): 1358 - 1369. [Full Text] [PDF]

				W. S. Jellish, B. Blakeman, P. Warf, and S. Slogoff Somatosensory Evoked Potential Monitoring Used to Compare the Effect of Three Asymmetric Sternal Retractors on Brachial Plexus Function Anesth. Analg., February 1, 1999; 88(2): 292 - 292. [Abstract] [Full Text] [PDF]