Document Detail


Anterior ischemic optic neuropathy after open heart operations.
MedLine Citation:
PMID:  8572784     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The overall incidence of anterior ischemic optic neuropathy after open heart operations at the Lahey Clinic is less than 0.5%. However, during the 2-year period, March 1, 1990, to March 1, 1992, an increased incidence (8 of 602 patients or 1.3%) of this complication was observed. METHODS: A rigorous analysis was conducted of all 602 patients who underwent operation during this period. RESULTS: No preoperative risk factors were identified. The development of anterior ischemic optic neuropathy was associated with prolonged cardiopulmonary bypass time, low hematocrit levels, excessive perioperative body weight gain, and the use of epinephrine and amrinone. Other hypothetical risk factors include systemic hypothermia, anemia, increased intraocular pressure, and microembolization. Treatment options include the use of corticosteroid medications, reduction of intraocular pressure, and optic nerve fenestration, although recent evidence and our experience indicate that the fenestration procedure is of no benefit. CONCLUSIONS: Because all methods of treatment have had limited success, efforts to prevent this complication are of paramount importance.
Authors:
O M Shapira; W A Kimmel; P S Lindsey; D M Shahian
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  61     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1996 Feb 
Date Detail:
Created Date:  1996-03-06     Completed Date:  1996-03-06     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  660-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Thoracic and Cardiovascular Surgery, Lahey Hitchcock Medical Center, Burlington, Massachusetts 01805, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Amrinone / adverse effects
Cardiac Surgical Procedures / adverse effects*
Cardiopulmonary Bypass / adverse effects
Epinephrine / adverse effects
Female
Hematocrit
Humans
Incidence
Male
Middle Aged
Optic Neuropathy, Ischemic / diagnosis,  epidemiology,  etiology*,  therapy
Retrospective Studies
Risk Factors
Weight Gain
Chemical
Reg. No./Substance:
51-43-4/Epinephrine; 60719-84-8/Amrinone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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