Informe de caso y revisión de la literatura sobre infarto retinal bilateral después de bypass cardiopulmonar en cirugía coronaria
A case report and brief review of the literature on bilateral retinal infarction following cardiopulmonary bypass for coronary artery bypass grafting.
Trethowan BA, Gilliland H, Popov AF, Varadarajan B, Phillips SA, McWhirter L, Ghent R.
J Cardiothorac Surg. 2011 Nov 21;6:154. doi: 10.1186/1749-8090-6-154.
Abstract
Postoperative visual loss is a devastating perioperative complication. The commonest aetiologies are anterior ischaemic optic neuropathy (AION), posterior ischaemic optic neuropathy (PION), and central retinal artery occlusion (CRAO). These appear to be related to certain types of operation, most commonly spinal and cardiac bypass procedures; with the rest divided between: major trauma causing excessive blood loss; head/neck and nasal or sinus surgery; major vascular procedures (aortic aneurysm repair, aorto-bifemoral bypass); general surgery; urology; gynaecology;liposuction; liver transplantation and duration of surgery. The non-surgical risk factors are multifactorial: advanced age, prolonged postoperative anaemia, positioning (supine v prone), alteration of venous drainage of the retina, hypertension, smoking, atherosclerosis, hyperlipidaemia, diabetes, hypercoagulability, hypotension, blood loss and large volume resuscitation. Other important cardiac causes are septic emboli from bacterial endocarditis and emboli caused by atrial myxomata. The majority of AION cases occur during CPB followed by head/neck surgery and prone spine surgery. CPB is used to allow coronary artery bypass grafting on a motionless heart. It has many side-effects and complications associated with its use and we report here a case of bilateral retinal infarction during routine coronary artery bypass grafting in a young male patient with multiple risk factors for developing this complication despite steps to minimise its occurrence.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3253690/pdf/1749-8090-6-154.pdf
Pérdida visual perioperatoria: ¿Que sabemos, que podemos hacer?
Perioperative visual loss: what do we know, what can we do?
Roth S.
Br J Anaesth. 2009 Dec;103 Suppl 1:i31-40. doi: 10.1093/bja/aep295.
Abstract
Perioperative visual loss (POVL), a rare, but devastating complication, can follow non-ocular surgery. Highest rates of visual loss are with cardiac and spine surgery. The main causes of visual loss after non-ocular surgery are retinal vascular occlusion and ischaemic optic neuropathy. This review updates readers on the incidence, suspected risk factors, diagnosis, and treatment of POVL due to these conditions.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2791856/pdf/aep295.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
A case report and brief review of the literature on bilateral retinal infarction following cardiopulmonary bypass for coronary artery bypass grafting.
Trethowan BA, Gilliland H, Popov AF, Varadarajan B, Phillips SA, McWhirter L, Ghent R.
J Cardiothorac Surg. 2011 Nov 21;6:154. doi: 10.1186/1749-8090-6-154.
Abstract
Postoperative visual loss is a devastating perioperative complication. The commonest aetiologies are anterior ischaemic optic neuropathy (AION), posterior ischaemic optic neuropathy (PION), and central retinal artery occlusion (CRAO). These appear to be related to certain types of operation, most commonly spinal and cardiac bypass procedures; with the rest divided between: major trauma causing excessive blood loss; head/neck and nasal or sinus surgery; major vascular procedures (aortic aneurysm repair, aorto-bifemoral bypass); general surgery; urology; gynaecology;liposuction; liver transplantation and duration of surgery. The non-surgical risk factors are multifactorial: advanced age, prolonged postoperative anaemia, positioning (supine v prone), alteration of venous drainage of the retina, hypertension, smoking, atherosclerosis, hyperlipidaemia, diabetes, hypercoagulability, hypotension, blood loss and large volume resuscitation. Other important cardiac causes are septic emboli from bacterial endocarditis and emboli caused by atrial myxomata. The majority of AION cases occur during CPB followed by head/neck surgery and prone spine surgery. CPB is used to allow coronary artery bypass grafting on a motionless heart. It has many side-effects and complications associated with its use and we report here a case of bilateral retinal infarction during routine coronary artery bypass grafting in a young male patient with multiple risk factors for developing this complication despite steps to minimise its occurrence.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3253690/pdf/1749-8090-6-154.pdf
Pérdida visual perioperatoria: ¿Que sabemos, que podemos hacer?
Perioperative visual loss: what do we know, what can we do?
Roth S.
Br J Anaesth. 2009 Dec;103 Suppl 1:i31-40. doi: 10.1093/bja/aep295.
Abstract
Perioperative visual loss (POVL), a rare, but devastating complication, can follow non-ocular surgery. Highest rates of visual loss are with cardiac and spine surgery. The main causes of visual loss after non-ocular surgery are retinal vascular occlusion and ischaemic optic neuropathy. This review updates readers on the incidence, suspected risk factors, diagnosis, and treatment of POVL due to these conditions.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2791856/pdf/aep295.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
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