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Related Experiment Videos

Brain microemboli during cardiac surgery or aortography.

D M Moody1, M A Bell, V R Challa

  • 1Department of Radiology, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC 27103.

Annals of Neurology
|October 1, 1990
PubMed
Summary

Microvascular changes like focal dilatations were observed in patients and dogs after cardiopulmonary bypass. These findings may explain neurological deficits following cardiac surgery.

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Area of Science:

  • Vascular Biology
  • Cardiovascular Surgery
  • Neurology

Background:

  • Cardiopulmonary bypass is a critical procedure in cardiac surgery.
  • Neurological deficits are a known complication after cardiac surgical procedures.
  • The underlying microvascular mechanisms remain incompletely understood.

Purpose of the Study:

  • To investigate microvascular changes in patients and animals following cardiopulmonary bypass.
  • To explore potential anatomical correlates for post-operative neurological dysfunction.

Main Methods:

  • Histopathological examination of microvasculature in patients and dogs.
  • Comparison between subjects who underwent cardiopulmonary bypass and control groups.
  • Observation of microvascular alterations such as focal dilatations and aneurysms.

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Main Results:

  • Focal dilatations and aneurysms in terminal arterioles and capillaries were observed in 4/5 patients and 6/6 dogs post-cardiopulmonary bypass.
  • Sausage-like dilatations were noted in medium-sized arterioles.
  • Similar, but fewer, changes were seen in two patients after proximal aortography; control groups showed no such changes.
  • Some dilatations exhibited birefringence and appeared empty, suggesting they might be sites of gas or fat emboli.

Conclusions:

  • Microvascular changes, including focal dilatations, occur specifically after major arterial interventions like cardiopulmonary bypass.
  • These observed microvascular events are a potential anatomical basis for neurological deficits and cognitive dysfunction seen in patients post-cardiac surgery.
  • Further research is warranted to confirm the role of these microvascular alterations in post-operative neurological complications.