Brain function monitoring during off-pump cardiac surgery: a case report.

Cases Journal
Paolo ZanattaCarlo Sorbara

Abstract

Early postoperative stroke is an adverse syndrome after coronary bypass surgery. This report focuses on overcoming of cerebral ischemia as a result of haemodynamic instability during heart enucleation in off-pump procedure. A 67 year old male patient, Caucasian race, with a body mass index of 28, had a recent non-Q posterolateral myocardial infarction one month before and recurrent instable angina. His past history includes an uncontrolled hypertension, dyslipidemia, insulin dependent diabetes mellitus, epiaortic vessel stenosis. The patient was scheduled for an off-pump procedure and monitored with bilateral somatosensory evoked potentials, whose alteration signalled the decrement of the cardiac index during operation.The somatosensory evoked potentials appeared when the blood pressure was increased with a pharmacological treatment. During the off-pump coronary bypass surgery, a lower cardiac index, predisposes patients, with multiple stroke risk factors, to a reduction of the cerebral blood flow. Intraoperative somatosensory evoked potentials monitoring provides informations about the functional status of somatosensory cortex to reverse effects of brain ischemia.

References

Apr 1, 1994·Acta Anaesthesiologica Scandinavica·T PorkkalaV Häkkinen
May 9, 2000·The Annals of Thoracic Surgery·J D PuskasW S Weintraub
Feb 19, 2004·British Journal of Anaesthesia·P-G ChassotD R Spahn
Mar 20, 2004·Neurophysiologie clinique = Clinical neurophysiology·Geneviève FlorenceBernard Gueguen
Nov 25, 2005·The Annals of Thoracic Surgery·Mark F BerryY Joseph Woo

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Citations

Jul 30, 2011·Journal of Cardiothoracic and Vascular Anesthesia·Paolo ZanattaCarlo Valfrè

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Methods Mentioned

BETA
coronary artery bypass
X-ray
Coronary

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