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Area of Science:

  • Neurology
  • Cardiovascular Surgery
  • Radiology

Background:

  • Cerebral microbleeds (CMBs) are linked to cardiovascular risk factors, cognitive decline, and dementia.
  • Causes include cerebral amyloid angiopathy, chronic hypertension, and diffuse axonal injury.
  • The incidence and location of new CMBs post-cardiac surgery, and their relation to cognition and risk factors, remain unstudied.

Purpose of the Study:

  • To investigate the frequency and location of new cerebral microbleeds (CMBs) after adult cardiac surgery.
  • To explore the association between new CMBs, perioperative risk factors, and postoperative cognitive function.

Main Methods:

  • Analysis of pre- and post-surgery magnetic resonance susceptibility-weighted images and neuropsychological tests in 75 cardiac surgery patients.
  • Identification of CMBs by a neuroradiologist blinded to clinical data using standardized criteria.

Main Results:

  • New CMBs were detected in 76% of patients post-cardiac surgery, predominantly in the frontal lobe.
  • New CMBs were associated with longer cardiopulmonary bypass times (P=0.003) and lower hematocrit (P=0.04).
  • Each minute of bypass time increased CMB odds by approximately 2% (OR, 1.02).

Conclusions:

  • New CMBs are common after cardiac surgery, with a global distribution favoring frontal and parietal lobes.
  • Cardiopulmonary bypass duration and reduced hematocrit are significant predictors of new CMBs.
  • Postoperative cognitive decline was observed in 44% of patients but did not correlate with new CMBs.