| Cerebral perfusion during off-pump coronary artery bypass grafting. | |
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MedLine Citation:
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PMID: 15170545 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: It is still unclear whether cerebral perfusion is affected during off-pump coronary bypass grafting (OPCABG). We investigated the predictive value of the neurobiochemical markers of brain damage and cerebral perfusion in relation to early neuropsychological outcome after OPCABG. METHODS: We performed OPCABG in ten patients (mean age, 63.4 +/- 5.5 years). A 5.5 F oximetric catheter was placed in the jugular bulb to continuously measure jugular oxygen saturation (SjO(2)) during OPCABG. We also examined the activity of daily living (ADL) index and performed the Mini-Mental State Examination (MMSE) to assess neuropsychological state preoperatively and 7 days postoperatively. Venous serum levels of neuron-specific enolase (NSE) and brain-specific creatine kinase (CK-BB) were measured preoperatively and 24 h after skin closure. RESULTS: The mean arterial blood pressure and the SjO(2) during anastomosis of the left circumflex coronary artery (Cx) were significantly lower than that of the left anterior descending coronary artery (LAD) (P < 0.001). None of the patients died. There was no transient or permanent neurologic deficit. Cognitive decline was evident in two patients with a low SjO(2) and a high postoperative NSE level. The postoperative CK-BB value was normal in all patients. CONCLUSIONS: Monitoring intraoperative continuous cerebral oxygen desaturation and postoperative NSE levels could be useful for predicting early neuropsychological outcome after OPCABG. |
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Authors:
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Masataka Yoda; Masaki Nonoyama; Tadayuki Shimakura |
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Publication Detail:
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Type: Clinical Trial; Journal Article |
Journal Detail:
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Title: Surgery today Volume: 34 ISSN: 0941-1291 ISO Abbreviation: Surg. Today Publication Date: 2004 |
Date Detail:
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Created Date: 2004-06-01 Completed Date: 2004-10-05 Revised Date: 2006-08-03 |
Medline Journal Info:
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Nlm Unique ID: 9204360 Medline TA: Surg Today Country: Japan |
Other Details:
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Languages: eng Pagination: 501-5 Citation Subset: IM |
Affiliation:
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Department of Cardiovascular Surgery, Fukuyama Circulation Hospital, Hiroshima, Japan. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Blood Pressure Brain / blood supply* Cognition Disorders / drug therapy* Coronary Artery Bypass / adverse effects*, methods Creatine Kinase / blood Extracorporeal Circulation / adverse effects* Female Humans Male Mental Status Schedule Middle Aged Phosphopyruvate Hydratase / blood Regional Blood Flow |
| Chemical | |
Reg. No./Substance:
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EC 2.7.3.2/Creatine Kinase; EC 4.2.1.11/Phosphopyruvate Hydratase |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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