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THE JOURNAL OF CARDIOVASCULAR SURGERY

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The Journal of Cardiovascular Surgery 2006 October;47(5):585-7

Copyright © 2006 EDIZIONI MINERVA MEDICA

language: English

Perioperative optic neuropathy following off-pump coronary artey bypass grafting

Onorati F. 1, De Feo M. 2, Santè P. 2, Renzulli A. 1, Cotrufo M. 2

1 Division of Cardiac Surgery Magna Graecia University, Catanzaro, Italy 2 Department of Cardiothoracic Sciences Second University of Naples, Naples, Italy


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Visual loss from ischemic perioperative optic neuropathy (PON) rarely occurs during the postoperative period of patients undergoing cardiac surgery. Since the first description, PON has been associated with cardiopulmonary bypass (CPB), being some CPB-related complications and epiphenomena considered the causes of such terrible complication. In particular, the risk for micro-embolization during aortic cannulation and clamping, the CPB-related inflammatory response, the hemodilution and the hypothermia during CPB could be responsible of PON. However, some cases of PON still remain idiopathic. We report here a very rare case of PON following off-pump surgery in a patient with severe coronary disease and multiorgan comorbidities. The case reported opens the debate on the potential mechanisms underlying PON, other than cardiopulmonary bypass.

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