Is the number of microembolic signals related to neurologic outcome in coronary bypass surgery?

Arquivos de Neuro-Psiquiatria

Suzana M. F. Malheiros²  Ayrton R. Massaro¹  Alberto A. Gabbai¹  Clodualdo J. N. Pessa¹  Luis R. Gerola¹  João N. R. Branco¹  Edgar B. Lira Filho¹  Dejaldo M. J. Christofalo¹  Darwin Federico¹  Antonio C. Carvalho¹  Enio Buffolo¹ 

[1] ,Universidade Federal de São Paulo Escola Paulista de Medicina Department of NeurologySão Paulo SP ,Brasil

关键词: coronary artery bypass;    transcranial Doppler;    postoperative complications;    cardiopulmonary bypass;    treatment outcome;    revascularização miocárdica;    ponte de artéria coronária;    complicações pós-operatórias;    Doppler transcraniano;    circulação extracorpórea;   

DOI  :  10.1590/S0004-282X2001000100002

来源: SciELO

【 摘 要 】

Coronary artery bypass surgery (CABG) without cardiopulmonary bypass (CPB) may potentially reduce the number of microembolic signals (MES) associated with aortic manipulation or generated by the pump circuit, resulting in a better neurologic outcome after surgery. Our aim was to compare the frequency of MES and neurologic complications in CABG with and without CPB. Twenty patients eligible to routine CABG without CPB were randomized to surgery with CPB and without CPB and continuously monitored by transcranial Doppler. Neurologic examination was performed in all patients before and after surgery. The two groups were similar with respect to demographics, risk factors, grade of aortic atheromatous disease and number of grafts. The frequency of MES in the nonCPB group was considerably lower than in CPB patients, however, we did not observe any change in the neurologic examination during the early postoperative period. Neurologic complications after CABG may be related to the size and composition of MES rather than to their absolute numbers. A large prospective multicentric randomized trial may help to elucidate this complex issue.

【 授权许可】

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