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Demonstration of cerebral microemboli occurring during coronary artery bypass graft surgery using fluorescein
J V Arnold1, C I Blauth, P L Smith
1Cardiac Surgery Unit, Hammersmith Hospital, London.
Insights
Coronary artery bypass graft surgery can cause neurological issues, likely due to cerebral microembolism. Studying the eye
Area of Science:
- Ophthalmology
- Neurology
- Cardiovascular Surgery
Background:
- Coronary artery bypass graft (CABG) surgery is linked to significant neurological and neuropsychological complications.
- Cerebral microembolism is considered the primary cause of post-CABG cerebral dysfunction.
- The eye provides a unique window into cerebral microcirculation due to its shared embryological origin with the brain.
Purpose of the Study:
- To investigate cerebral microcirculation changes during CABG surgery.
- To utilize the eye as a model for studying cerebral microvascular events.
- To demonstrate the utility of retinal fluorescein angiography in this context.
Main Methods:
- Retinal fluorescein angiography was performed during coronary artery bypass graft surgery.
- The technique allowed for in-vivo visualization of microcirculatory changes.
- This method assessed alterations in the cerebral microvasculature.
Main Results:
- Retinal fluorescein angiography successfully demonstrated changes in cerebral microcirculation during CABG.
- The study visualized microcirculatory alterations in real-time during the surgical procedure.
- Specific changes observed in retinal vasculature correlated with potential cerebral events.
Conclusions:
- Retinal fluorescein angiography is a viable tool for monitoring cerebral microcirculation during CABG.
- Understanding these microcirculatory changes can help mitigate neurological complications.
- The eye serves as a valuable, accessible model for studying brain microvascular health.
Abstract:
Coronary artery bypass graft surgery is associated with an unacceptably high incidence of neurological and neuropsychological complications (Breur et al., 1981; Smith, 1988). The main cause of cerebral dysfunction following this type of surgery is probably cerebral microembolism (Dutton et al., 1974; Taylor, 1986). The eye is an outgrowth of the brain and therefore is uniquely suitable for the study of cerebral microcirculation. Retinal fluorescein angiography has been employed during this surgical procedure to demonstrate the changes which occur in the cerebral microcirculation during operation.