Key result
Simultaneous carotid-coronary interventions and isolated CABG are both linked to decreased regional cerebral blood flow.
Why the study?
The study was conducted to compare and assess cerebral perfusion by SPECT after coronary artery bypass grafting versus simultaneous interventions on the carotid and coronary arteries.
Does simultaneous intervention on coronary and carotid arteries compared to CABG alone affect cerebral perfusion in cardiac surgical patients?
Observational (n=34)
Does simultaneous intervention on coronary and carotid arteries compared to CABG alone affect cerebral perfusion in cardiac surgical patients?
Both CABG and simultaneous coronary/carotid interventions under cardiopulmonary bypass are associated with significant regional decreases in cerebral blood flow, though patients with combined disease have lower baseline perfusion.
Perfusion monitoring may warrant consideration in these patients; leaves open whether simultaneous intervention adds risk beyond CABG alone.
Goal of investigation was comparison and assessment of the state of cerebral perfusion according to SPECT data after coronary artery bypass grafting and simultaneous surgical intervention on the carotid and coronary arteries. Brain perfusion data were studied in 34 cardiac surgical patients who underwent surgical correction under conditions of cardiopulmonary bypass: simultaneous intervention on the coronary and carotid arteries (n = 21) and coronary artery bypass grafting (n = 13). The study of the brain was carried out by SPECT with the radiopharmaceutical 99mTc-HMPAO (Ceretek). In the group with CABG, there was a statistically significant decrease in the CBF values in the region of the caudate nucleus on the right, in both occipital and parietal lobes (p = 0.004193). In the group with simultaneous interventions, a significant decrease in the CBF indices in the right occipital and left parietal lobes (p = 0.020672), an increase in the indices in the left temporal lobe (p = 0.011286) was revealed. CBF indicators in the group with simultaneous interventions are significantly lower than those in the group with CABG both in the preoperative and postoperative periods. The data obtained indicate that patients with combined atherosclerotic lesions of the coronary and carotid arteries have significantly lower values of the CBF in comparison with patients with isolated changes in the coronary arteries. Coronary artery bypass grafting and simultaneous surgical interventions on the carotid and coronary arteries under cardiopulmonary bypass may be accompanied by a significant decrease in regional cerebral blood flow in certain areas of the brain, and these changes in the CABG group can be traced in a larger number of analyzed areas.
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Korotkevich et al. (2022) conducted an observational in Combined atherosclerotic lesions of the coronary and carotid arteries vs isolated changes in the coronary arteries (n=34). Simultaneous surgical intervention on the carotid and coronary arteries vs. Coronary artery bypass grafting (CABG) alone was evaluated on Changes in regional cerebral blood flow (CBF) according to SPECT data. Simultaneous carotid and coronary interventions and isolated CABG both significantly decreased regional cerebral blood flow, though patients with combined lesions had lower baseline and postoperative flow.
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