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Related Experiment Videos

Cerebral cortical oxygenation changes during OPCAB surgery.

Sudath P Talpahewa1, Raimondo Ascione, Gianni D Angelini

  • 1Bristol Heart Institute, University of Bristol, Bristol, United Kingdom.

The Annals of Thoracic Surgery
|November 7, 2003
PubMed
Summary
This summary is machine-generated.

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Off-pump coronary artery bypass surgery can alter brain oxygenation. Left anterior descending artery grafting causes persistent changes, while other grafts result in temporary effects, highlighting the need for protective measures.

Area of Science:

  • Cardiovascular Surgery
  • Neuroscience
  • Medical Technology

Background:

  • Investigating cerebral cortical oxygenation during off-pump coronary artery bypass (OPCAB) surgery.
  • Utilizing near-infrared spectroscopy (NIRS) to monitor brain oxygenation changes.

Purpose of the Study:

  • To assess changes in cerebral cortical oxygenation during OPCAB surgery.
  • To differentiate the impact of grafting different coronary arteries on brain oxygenation.

Main Methods:

  • Measured deoxygenated hemoglobin [HHb], oxygenated hemoglobin [O(2)Hb], cytochrome c oxidase [Cyt-Ox] redox status, tissue oxygenation index (TOI), and tissue hemoglobin index (THI).
  • Monitored 23 patients during grafting of the left anterior descending (LAD), posterior descending (PDA), and circumflex (Cx) arteries.

Related Experiment Videos

  • Recorded measurements at baseline, during stabilizer placement, and post-anastomosis completion.

    • Main Results:

    • LAD grafting led to decreased [O(2)Hb] and cerebral saturation, with persistent changes post-procedure.
    • PDA grafting caused decreased [O(2)Hb], increased [HHb], and reduced cerebral saturation.
    • Cx grafting resulted in increased [HHb], reduced cerebral saturation, and increased cerebral blood volume (CBV).
    • No significant changes in [Cyt-Ox] redox state were observed during grafting, but a reduction occurred post-LAD grafting.

    Conclusions:

    • LAD grafting during OPCAB surgery induces persistent cerebral oxygenation changes.
    • Cx and PDA grafting result in transient, reversible alterations in cerebral oxygenation.
    • Trendelenburg positioning and lateral tilting may protect against cerebral ischemia during lateral and posterior wall grafting.