Measures to Prevent Neurologic Deficits in Urgent CABG Surgery With Bilateral Carotid Occlusion

Area of Science:

• Cardiovascular Surgery
• Neurology
• Medical Devices

Background:

• Coronary artery bypass graft surgery (CABG) poses significant neurologic risks for patients with bilateral high-degree carotid stenosis or occlusion.
• Previous successful CABG in similar patients utilized electroencephalography or near-infrared spectroscopy for cerebral blood flow monitoring.

Observation:

• This case report focuses on a patient with bilateral carotid occlusion undergoing CABG.
• The study employed pulsatile flow during cardiopulmonary bypass.
• Transcranial Doppler (TCD) was utilized for real-time cerebral blood flow monitoring.

Findings:

• Successful CABG was achieved in the patient with bilateral carotid occlusion.
• Pulsatile flow on cardiopulmonary bypass, combined with TCD monitoring, provided a safe surgical approach.
• Real-time analysis of cerebral blood flow changes was possible without lag.

Implications:

• This combined technique offers a potentially safer method for managing high-risk CABG patients with bilateral carotid occlusion.
• Real-time TCD monitoring allows for immediate assessment and management of cerebral perfusion during complex cardiac surgery.
• Further research into this approach could refine perioperative neuroprotection strategies in cardiovascular surgery.