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A functional evaluation of cerebral perfusion for coronary artery bypass grafting patients

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Abstract

We evaluate the utility of providing a pulsatile blood flow by applying off-pump coronary artery bypass grafting (CABG) or intra-aortic balloon pumping (IABP) with conventional CABG to prevent perioperative stroke in patients with cerebral hypoperfusion on single-photon emission-computed tomography (SPECT). A total of 286 patients underwent isolated CABG with a cerebral magnetic resonance angiography (MRA) evaluation between 2006 and 2015. Seventy-five had significant stenosis and/or occlusion of craniocervical vessels; the other 211 had no significant stenosis. Cerebral SPECT was performed for 49 (SPECT group) of the 75 patients. The SPECT group was further divided into a normal perfusion (NP) (n = 37); and a hypoperfusion (HP) (n = 12). In the present study we compared the NP group and the 211 patients with no significant stenosis (as a control group) to the HP group. No strokes occurred in the HP group, and 1 stroke occurred at the time of operation in the control group. Postoperative stroke within 30 days occurred in 3 patients in the control group; the difference was not statistically significant. The long-term stroke-free rates of the HP and Control group did not differ to a statistically significant extent. The functional evaluation of cerebral perfusion by SPECT is important when patients have significant stenotic lesions on cerebral MRA. Maintaining an adequate pulsatile flow by off-pump CABG or IABP with conventional CABG will help prevent perioperative stroke, even if cerebral hypoperfusion is detected by SPECT.

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Authors and Affiliations

  1. Division of Cardiac Surgery, Toyota Kosei Hospital, Toyota, Aichi, Japan

    Chikao Teramoto, Osamu Kawaguchi & Yoshimori Araki

  2. Division of Radiology, Toyota Kosei Hospital, Toyota, Aichi, Japan

    Joe Matsuda

  3. Division of Cardiac Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan

    Chikao Teramoto, Masato Mutsuga & Akihiko Usui

Authors
  1. Chikao Teramoto
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  2. Masato Mutsuga
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  3. Osamu Kawaguchi
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  4. Yoshimori Araki
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  5. Joe Matsuda
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  6. Akihiko Usui
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Correspondence to Chikao Teramoto.

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Teramoto, C., Mutsuga, M., Kawaguchi, O. et al. A functional evaluation of cerebral perfusion for coronary artery bypass grafting patients. Heart Vessels 34, 1122–1131 (2019). https://doi.org/10.1007/s00380-019-01348-7

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