British Journal of Anaesthesia, 2000, Vol. 84, No. 5 629-631
© 2000 The Board of Management and Trustees of the British Journal of Anaesthesia
Short Communication |
Reduced cerebral embolic signals in beating heart coronary surgery detected by transcranial Doppler ultrasound
1 Sir Humphry Davy Department of Anaesthesia, Bristol Royal Infirmary, Marlborough Street, Bristol BS2 8HW and
2 Bristol Heart Institute, Bristol Royal Infirmary, Marlborough Street, Bristol BS2 8HW, UK
M. P. R. Watters, Sir Humphry Davy Department of Anaesthesia, Bristol Royal Infirmary, Marlborough Street, Bristol BS2 8HW
Cerebral emboli detected by transcranial Doppler imaging were recorded in 20 patients undergoing multiple-vessel coronary artery bypass surgery, either with or without cardiopulmonary bypass, in a prospective unblinded comparative study. Emboli were recorded continuously from the time of pericardial incision until 10 min after the last aortic instrumentation. The numbers of coronary grafts and of aortic clampings were also documented. Patients undergoing revascularization with cardiopulmonary bypass had more emboli (median 79, range 38–876) per case compared with patients having off-pump surgery (median 3, range 0–18). No clinically detectable neurological deficits were seen in either group. Beating heart surgery is associated with fewer emboli than coronary surgery with cardiopulmonary bypass. Further research is necessary to determine whether a smaller number of emboli alters the incidence of neurological deficit after cardiac surgery.
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