Document Detail


Brain magnetic resonance imaging in coronary artery bypass grafts: a pre- and postoperative assessment.
MedLine Citation:
PMID:  8469339     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We undertook a study to determine (1) the frequency and prognostic significance of preexisting MRI brain abnormalities in patients undergoing coronary artery bypass grafts (CABG) and (2) whether MRI can detect surgery-related brain damage in 31 neurologically asymptomatic CABG patients (mean age, 61.0 +/- 6.6 years). MRIs were performed within 7 days before and 8 to 17 days after surgery. When we compared the preoperative images with those of 31 age- and risk factor-matched neurologically asymptomatic controls free of cardiac disease (mean age, 60.3 +/- 6.1 years), higher rates of thromboembolic infarcts (16% versus 0%), lacunes (58.1% versus 32.3%), and brainstem lesions (22.6% versus 3.8%) were noted. Subjective rating demonstrated significantly larger ventricles in patients than in controls (p = 0.002). CABG candidates also had significantly increased ventricular-to-intracranial cavity ratios (VICR) as determined by semiquantitative volumetric measurements (6.9 +/- 2.5% versus 4.9 +/- 1.6%; p = 0.0004). Eleven patients had postsurgical complications, with eight having symptoms consistent with diffuse encephalopathy. The only MRI finding that separated encephalopathic from complication-free patients was ventricular size (VICR 9.0 +/- 2.5% versus 4.9 +/- 1.6%; p = 0.006). This difference remained statistically significant after adjustment for the effects of age (p = 0.04). Postoperative MRI consistently failed to demonstrate surgery-related brain damage responsible for the encephalopathy.
Authors:
R Schmidt; F Fazekas; H Offenbacher; H Mächler; W Freidl; F Payer; B Rigler; M I Harrison; H Lechner
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Neurology     Volume:  43     ISSN:  0028-3878     ISO Abbreviation:  Neurology     Publication Date:  1993 Apr 
Date Detail:
Created Date:  1993-05-11     Completed Date:  1993-05-11     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  775-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Neurology, Karl-Franzens University Graz, Austria.
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MeSH Terms
Descriptor/Qualifier:
Aged
Brain Diseases / diagnosis*,  epidemiology,  etiology
Brain Ischemia / diagnosis,  etiology
Coronary Artery Bypass / adverse effects*
Coronary Disease / complications,  surgery
Evaluation Studies as Topic
Female
Humans
Incidence
Magnetic Resonance Imaging*
Male
Middle Aged
Prognosis
Prospective Studies
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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