Cerebral ischemic disorders and cerebral oxygen balance during cardiopulmonary bypass surgery: preoperative evaluation using magnetic resonance imaging and angiography

Anesthesia and Analgesia
T GotoH Uozumi

Abstract

We compared the preoperative prevalence of small cerebral infarctions and carotid stenosis to jugular venous oxygen saturation (Sjvo2) during coronary artery bypass grafting (CABG). Sjvo2 served as an indicator of whether cerebral oxygen supply meets demand in patients on cardiopulmonary bypass (CPB). The study population consisted of 121 patients who were either older than 65 yr or had a history of cerebrovascular disease. The patients underwent preoperative cerebral magnetic resonance imaging (MRI) and cervical magnetic resonance angiography (MRA) to detect small cerebral infarctions and carotid artery stenosis. Patients with atherosclerosis of the ascending aorta were identified by intraoperative epiaortic ultrasonography. Liberation of emboli from the aorta in these patients was prevented by modification of the standard operation. From preoperative MRI and MRA, 65 patients (54%) had small cerebral infarctions in the white matter or basal ganglia and nine patients (7%) demonstrated moderate or severe stenosis in the carotid arteries. Thirteen patients (11%) had moderate or severe atheromatous disease of the ascending aorta. The severity of aortic atherosclerosis was significantly correlated with the grade of carotid stenosis...Continue Reading

References

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Citations

Feb 16, 2000·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·N OkanoF Goto
Apr 6, 2000·The Annals of Thoracic Surgery·T GotoR Sakata
Feb 13, 2001·Anaesthesia·M Shaaban AliI Latto
Apr 22, 2006·Stroke; a Journal of Cerebral Circulation·Paula M BokeschSvetlana A Dambinova
Apr 18, 2009·Anesthesia and Analgesia·Glenn S MurphyRobert C Groom
Aug 31, 2004·Anesthesia and Analgesia·Shahar Bar-YosefUNKNOWN Neurological Outcome Research Group and C.A.R.E. Investigators of the Duke Heart Center

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