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Horner's syndrome after coronary artery bypass surgery

From the Departments of Neurology, Cardiothoracic Surgery, and Ophthalmology, Cornell University Medical College, New York, NY.
Received February 13, 1995. Accepted in final form April 27, 1995.
Address correspondence and reprint requests to Dr. Denise Barbut, New York Hospital, Starr-607, 520 East 70th Street, New York, NY 10021.

Article abstract-We established the frequency of Horner's syndrome (HS) in 248 elective patients after coronary artery bypass surgery. Patients were evaluated neurologically pre- and post-operatively and 6 months after surgery. Nineteen patients (7.7%) developed unilateral HS postoperatively, 12 involving the left eye. The finding persisted in 10 patients (4%) at 6 months. When assessed 2 to 6 days, or 6 months, postoperatively, HS tended to be isolated and not associated with C8/T1 plexopathy. Among nondiabetic subjects, hypertensive patients had a higher frequency of HS than normotensive patients (10.6% versus 2.9%, p = 0.05). Among normotensive subjects, diabetic patients had a higher frequency than nondiabetic patients (15% versus 2.9%, p = 0.08). There was no association between HS, age, sex, internal mammary artery grafting, or length of cardiopulmonary bypass time. In summary, HS is a common and sometimes persistent complication of coronary artery bypass surgery. Hypertensive, and possibly diabetic, patients appear to be at greatest risk for developing HS.

NEUROLOGY 19;: 181-184

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