Abstract

The propose of this exploratory study was to gather data for analysis on possible predisposing or related factors in the development of neurological com plications following open heart surgery as well as to determine the scope and frequency of symptoms exhibited, indicative of cerebral damage. In addition, the researcher hoped to learn the outcome of these patients through information on the duration and resolution of symptoms, noting type and degree of residual problems as well as the incidence of mortality. A review of the literature provided background information for this study. This review indicated that although considerable attention has been given to the prevention of cerebral problems, relatively little is available dealing with the complications per se, or progress and prognosis in patients when these are present. Although a variety of causative factors in the development of these complications was suggested, recent studies indicated that air emboli and hypoxia, due to low perfusion, were the primary causes. Many writers indicated that such problems, if not immediately fatal, were usually transitory in nature, but provided little empirical data to support this. Data were collected from medical records of patients who under went open heart surgery in a teaching hospital on the west coast during the five year period from January 1, 1960 to December 31, 1964. Specific information was obtained from the charts of patients who had developed neurological complications of a motor or sensory nature. Of the 314 charts studied, 20 met the criteria for inclusion in this group. Data from each chart were first recorded on individual data collection sheets, and then transferred to a master chart. The data were tabulated and analyzed according to frequencies and certain relationships. Since 95 percent had left-sided heart lesions and atrial septal defects, these defects were concluded to be predisposing to neurological complications. Similarly, right anterolateral and sternal-splitting incisions, accompanied by left and supine operative positions were employed in 90 percent of the cases and are also considered predisposing factors. Neurological symptoms occurring most frequently included slow awakening of the patient following surgery, a stuporous or comatose state, hemiparesis, and impaired speech. All of the above signs were present in 65 percent or more of the cases. Follow-up on these patients established that 35 percent had expired, 40 per cent had complete resolution of symptoms and 35 percent had residual neurological problems at the time of this study. The over-all incidence of neurological complications in patients operated on for intracardiac lesions during the five-year period was six and one-half percent.

LLU Discipline

Nursing

Department

Nursing

School

Graduate School

First Advisor

Julia Bensonhaver

Second Advisor

Frances Fickess

Third Advisor

Ellsworth E. Wareham

Degree Name

Master of Science (MS)

Degree Level

M.S.

Year Degree Awarded

1965

Date (Title Page)

6-1965

Language

English

Library of Congress/MESH Subject Headings

Heart Surgery

Type

Thesis

Page Count

ix; 64

Digital Format

PDF

Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.

Collection

Loma Linda University Electronic Theses and Dissertations

Collection Website

http://scholarsrepository.llu.edu/etd/

Repository

Loma Linda University. Del E. Webb Memorial Library. University Archives

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