| Cerebral hemodynamics during coronary artery bypass graft surgery: the effect of carotid stenosis. | |
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MedLine Citation:
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PMID: 19540657 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article; Research Support, N.I.H., Extramural Date: 2009-06-21 |
Journal Detail:
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Title: Ultrasound in medicine & biology Volume: 35 ISSN: 1879-291X ISO Abbreviation: Ultrasound Med Biol Publication Date: 2009 Aug |
Date Detail:
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Created Date: 2009-07-20 Completed Date: 2009-11-04 Revised Date: 2011-09-26 |
Medline Journal Info:
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Nlm Unique ID: 0410553 Medline TA: Ultrasound Med Biol Country: England |
Other Details:
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Languages: eng Pagination: 1235-41 Citation Subset: IM |
Affiliation:
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Geriatric Research, Education, and Clinical Center, Boston, MA 02130, USA. jrudolph@partners.org |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged 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 Hematocrit Humans Male Middle Aged Middle Cerebral Artery / ultrasonography* Oxygen / blood Prospective Studies Pulsatile Flow Ultrasonography, Doppler, Transcranial Vascular Resistance |
| Grant Support | |
ID/Acronym/Agency:
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AG000294/AG/NIA NIH HHS; AG029861/AG/NIA NIH HHS; AG030967/AG/NIA NIH HHS; AG08812/AG/NIA NIH HHS; K23 AG030967-01A1/AG/NIA NIH HHS; R03 AG029861-02/AG/NIA NIH HHS |
| Chemical | |
Reg. No./Substance:
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124-38-9/Carbon Dioxide; 7782-44-7/Oxygen |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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