Original article: cardiovascularMagnetic resonance imaging findings and postoperative neurologic dysfunction in elderly patients undergoing coronary artery bypass grafting
Section snippets
Material and methods
Data were prospectively collected on 421 Japanese patients older than 60 years who underwent elective CABG by a single surgeon at Kumamoto Chuo Hospital between January 1995 and June 1999. There were 351 asymptomatic patients who had no history of stroke or transient ischemic attack, and 71 with a history of stroke or transient ischemic attack. Patients who underwent cardiac valve replacement or ventricular aneurysmectomy were excluded to eliminate the effects of intracardiac air embolism and
Results
Of the 421 patients studied, 126 patients (30%) had small infarctions, and 83 (20%) had multiple infarctions; of the latter, 72 had multiple small infarctions, and 11 had broad infarctions. There was an increase in infarctions with age compared with control patients (p = 0.052). Preoperative and intraoperative characteristics for all patients are summarized in Table 1. In general, the patients with multiple infarctions had more atherosclerotic risk factors than the patients in the other two
Comment
The incidence of NP dysfunction and stroke after CABG was demonstrated to increase in patients who had a higher grade of MRI finding in the brain. Multivariate analysis confirmed that the independent risks for multiple infarctions and broad infarctions were history of CVD, renal insufficiency, cognitive decline, and cerebral arteriosclerosis.
Small cerebral infarctions are common in elderly patients undergoing CABG [6]. Of 83 patients with multiple small infarctions or broad infarctions, 49
Acknowledgements
The authors thank Yasuhiko Matsukado, MD, for his critical comments and suggestions, and Jon Moon, MD, for his editorial assistance.
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