Original ArticlesPattern and significance of cerebral microemboli during coronary artery bypass grafting
Section snippets
Material and methods
Forty-one consecutive patients undergoing isolated CABG with TCD monitoring at the Austin and Repatriation Medical Centre were enrolled in this study. We also studied a subgroup of 32 patients to compare microembolic load and early neuropsychologic outcomes. Patients who had hypertension or who were over 70 years of age were specifically targeted. This group was targeted because of their increased risk of ascending aortic atheroma 14, 15, which could be a source of embolic material. Patients
Results
The mean age of the 41 patients enrolled in this study was 69.8 ± 6.9 years. There were 31 mean and 10 women. The mean cholesterol level was 5.6 ± 1.4 mmol/L. There were 34 previous smokers and 7 nonsmokers. Concurrent conditions included diabetes mellitus in 29%, hypertension in 56%, and peripheral vascular disease in 27%. Of these 41 patients, 36 had adequate transtemporal windows to allow perioperative bilateral TCD monitoring. The largest MES load occurred during the period of
Comment
Recent advances in surgical and anesthetic techniques have markedly reduced the operative risks of CABG. Cerebral complications, however, are still a major cause of morbidity and mortality and consequently also have a major economic impact. The hospital stay of patients who suffer a neurologic event is significantly prolonged [20] and the latter consequences of impaired neurologic function and cognitive behavior can significantly reduce the ability to return to a full and productive lifestyle.
Acknowledgements
Doctor Stephen Sylivris holds a scholarship from the National Heart Foundation of Australia.
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