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Evidence suggestive of diffuse brain damage following cardiac operations


Lancet 1(8381): 816-820
Evidence suggestive of diffuse brain damage following cardiac operations
In 37 patients regional cerebral blood flow (rCBF) was measured by single photon emission computerized tomography (SPECT) after inhalation of 133Xe before and within the 1st 10 days after open heart surgery for acquired or congenital heart disease. None of the patients had motor deficits postoperatively and no focal abnormalities were disclosed by the rCBF tomograms. rCBF was generally reduced and mean CBF fell from a normal value of 53.5 to 44.7 ml/100 g .cntdot. min (P < 0.001). Changes in rCBF occurred uniformly throughout the brain. The reduction in CBF correlated positively with increasing years (P < 0.05), duration of extracorporeal circulation (P < 0.05) and low mean arterial blood pressure during the bypass (P < 0.02). It was generally more pronounced after valve replacement than after coronary bypass (P < 0.16). In 11 patients investigated 1 yr after surgery CBF remained slightly reduced, 50.5 ml/100 g .cntdot. min (P < 0.05). No CBF reduction occurred in a control group of 15 patients who underwent carotid endarterectomy or extracranial-intracranial shunt operations. The findings are consistent with the suggestion that the extracorporeal circulation causes early postoperative CNS dysfunction.

Accession: 005411917

PMID: 6143139

DOI: 10.1016/S0140-6736(84)92271-2

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