Document Detail

Cerebral hemodynamics during coronary artery bypass graft surgery: the effect of carotid stenosis.
MedLine Citation:
PMID:  19540657     Owner:  NLM     Status:  MEDLINE    
Carotid stenosis is a frequent coexisting condition in patients undergoing coronary artery bypass graft (CABG) surgery. The impact of carotid stenosis on cerebral perfusion is not fully understood. The purpose of this study was to determine the impact of carotid stenosis on cerebral blood flow velocity in patients undergoing CABG. Seventy-three patients undergoing CABG were prospectively recruited and underwent preoperative Duplex carotid ultrasound to evaluate the degree of carotid stenosis. Intraoperatively, transcranial Doppler ultrasound was used to record the mean flow velocity (MFV) within the bilateral middle cerebral arteries. In addition, during the period of cardiopulmonary bypass, regulators of cerebral hemodynamics such as hematocrit, partial pressure of carbon dioxide and temperature were recorded. The ipsilateral middle cerebral artery mean flow velocity was compared in arteries with and without carotid stenosis using a repeated measures analysis. Seventy-three patients underwent intraoperative monitoring during CABG and 30% (n=22) had carotid stenosis. Overall, MFV rose throughout the duration of CABG including when the patient was on cardiopulmonary bypass. However, there was no significant MFV difference between those arteries with and without stenosis (F=1.2, p=.21). Further analysis during cardiopulmonary bypass, demonstrated that hemodilution and partial pressure of carbon dioxide may play a role in cerebral autoregulation during CABG. Carotid stenosis did not impact mean cerebral blood flow velocity during CABG. The cerebrovascular regulatory process appears to be largely intact during CABG.
James L Rudolph; Farzaneh A Sorond; Val E Pochay; Miguel Haime; Patrick Treanor; Michael D Crittenden; Viken L Babikian
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2009-06-21
Journal Detail:
Title:  Ultrasound in medicine & biology     Volume:  35     ISSN:  1879-291X     ISO Abbreviation:  Ultrasound Med Biol     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-20     Completed Date:  2009-11-04     Revised Date:  2014-09-21    
Medline Journal Info:
Nlm Unique ID:  0410553     Medline TA:  Ultrasound Med Biol     Country:  England    
Other Details:
Languages:  eng     Pagination:  1235-41     Citation Subset:  IM    
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MeSH Terms
Blood Flow Velocity
Blood Pressure
Carbon Dioxide / blood
Carotid Stenosis / blood,  physiopathology*,  ultrasonography
Case-Control Studies
Cerebrovascular Circulation*
Chi-Square Distribution
Coronary Artery Bypass*
Coronary Disease / blood,  physiopathology*,  ultrasonography
Middle Aged
Middle Cerebral Artery / ultrasonography*
Oxygen / blood
Prospective Studies
Pulsatile Flow
Ultrasonography, Doppler, Transcranial
Vascular Resistance
Grant Support
AG000294/AG/NIA NIH HHS; AG029861/AG/NIA NIH HHS; AG030967/AG/NIA NIH HHS; AG08812/AG/NIA NIH HHS; K23 AG030967/AG/NIA NIH HHS; K23 AG030967-01A1/AG/NIA NIH HHS; R03 AG029861/AG/NIA NIH HHS; R03 AG029861-02/AG/NIA NIH HHS
Reg. No./Substance:
142M471B3J/Carbon Dioxide; S88TT14065/Oxygen

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

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