[Cerebral infarction after coronary artery bypass surgery--its cause, management and prevention]

Among 535 cases of simple CABG, cerebral infarction was complicated in 5 cases (0.9%). Their mean age (65.2 years old) was high, and 80% of them had the history of hypertension or diabetes mellitus or both. The causes of the cerebral infarction were considered to be the embolism of atheromatous debris from the ascending aorta (3 cases), the cerebral hypoperfusion due to cerebral arterial disease and hypotension during cardiopulmonary bypass (1 cases), and the embolism of the left atrial thrombus formed during repeated supraventricular tachyarrhythmias (1 case). Both cases of the multiple infarctions were lost in-hospital 10 months and 21 months postoperatively. Two of the three cases of single infarction suffered from the permanent neurological deficits. To prevent cerebral infarction which might totally deprive of the efficacy of the CABG, it is important to check and properly manage the atheromatous change of the ascending aorta, the cerebral arterial disease, and also postoperative supraventricular tachyarrhythmias.