Document Detail


Cerebral emboli detected during bypass surgery are associated with clamp removal.
MedLine Citation:
PMID:  7974579     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Transcranial Doppler ultrasonography detects embolic signals during coronary artery bypass surgery. The relationship between embolization and specific events of bypass surgery is unclear. METHODS: With this technique, 20 patients undergoing bypass surgery were continuously monitored from inception to discontinuation of bypass. RESULTS: Embolic signals were detected in all patients. Of all embolic signals, 34% were detected as aortic cross-clamps were removed, and another 24% as aortic partial occlusion clamps were removed. Only 5% were detected at inception of bypass. Rates for embolization were 15.15 embolic signals per minute at cross-clamp removal, 10.9 embolic signals per minute at partial occlusion clamp removal, and fewer than 3 embolic signals per minute at other times. Correlation was found between the number of emboli, severity of aortic atheromatosis, and neurocognitive deterioration. CONCLUSIONS: The majority of emboli detected during coronary artery bypass grafting are associated with the release of clamps. Clamp manipulation may lead to release of aortic atheromatous debris. These emboli may be relevant to neurocognitive outcome.
Authors:
D Barbut; R B Hinton; T P Szatrowski; G S Hartman; M Bruefach; P Williams-Russo; M E Charlson; J P Gold
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  25     ISSN:  0039-2499     ISO Abbreviation:  Stroke     Publication Date:  1994 Dec 
Date Detail:
Created Date:  1994-12-29     Completed Date:  1994-12-29     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  2398-402     Citation Subset:  IM    
Affiliation:
Department of Neurology, Cornell University Medical College, New York Hospital, NY 10021.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Aorta / surgery
Aortic Diseases / complications
Arteriosclerosis / complications
Cardiopulmonary Bypass* / instrumentation,  methods
Cerebrovascular Disorders / etiology
Cohort Studies
Constriction
Coronary Artery Bypass* / instrumentation,  methods
Female
Humans
Intracranial Embolism and Thrombosis / etiology,  ultrasonography*
Language
Male
Memory / physiology
Middle Aged
Monitoring, Intraoperative
Prospective Studies
Psychomotor Performance / physiology
Ultrasonography, Doppler, Transcranial*
Ultrasonography, Interventional*

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


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