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Updated: May 9, 2026
Mouse Cardiac Arrest Model for Brain Imaging and Brain Physiology Monitoring During Ischemia and Resuscitation
Published on: April 14, 2023
Brain protection during cardiac surgery: circa 2012
1Department of Cardiothoracic Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157, USA. jhammon@wfubmc.edu
Insights
Preventing brain injury during cardiac surgery is possible by minimizing emboli from the cardiopulmonary bypass machine and aorta. These strategies significantly reduce the risk of disabling cognitive dysfunction and stroke-like symptoms.
Area of Science:
- Neurology
- Cardiovascular Surgery
- Medical Engineering
Background:
- Cardiac surgery poses a risk of brain injury, leading to cognitive dysfunction or stroke-like symptoms.
- Emboli from cardiopulmonary bypass, aortic manipulation, or cardiac chambers are primary causes of this neurological damage.
Purpose of the Study:
- To outline preventive strategies against brain injury during cardiac surgery.
- To highlight methods for minimizing embolic events and subsequent neurocognitive damage.
Main Methods:
- Avoiding aortic manipulation during surgery.
- Implementing filters for cardiopulmonary bypass inflow.
- Preventing air entry into the bypass pump and ensuring thorough cardiac deairing.
- Processing shed blood with a cell saver.
Main Results:
- These preventive measures can minimize or avoid brain inflammation.
- Long-term neurocognitive damage has been largely prevented in high-risk surgical patients.
Conclusions:
- Implementing specific procedural modifications can effectively prevent or reduce brain injury during cardiac surgery.
- The described preventive strategies are crucial for improving patient outcomes and reducing long-term neurological deficits.
Abstract:
Brain injury during cardiac surgery can cause a potentially disabling syndrome consisting mainly of cognitive dysfunction but can manifest itself as symptoms and signs indistinguishable from frank stroke. The cause of the damage is mainly the result of emboli consisting of solid material such as clots or atherosclerotic plaque, fat, and/or gas. These emboli enter the cerebral circulation from the cardiopulmonary bypass machine, break off the aorta during manipulation, and enter the circulation from cardiac chambers. This damage can be prevented or at least minimized by avoiding aortic manipulation, filtering aortic inflow from the pump, preventing air from entering the pump plus careful deairing of the heart. Shed blood from the cardiotomy suction should be processed by a cell saver whenever possible. By doing these maneuvers, inflammation of the brain can be avoided. Long-term neurocognitive damage has been largely prevented in large series of patients having high-risk surgery, which makes these preventive measures worthwhile.
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