Prediction of Postoperative Cerebral Infarction after Cardiovascular Surgery Using Quantitative Measurement of Cerebral Blood Flow with Brain Single-Photon Emission Computed Tomography.

Abstract

Prediction of postoperative cerebral infarction after cardiovascular surgery is difficult. The present study investigated whether quantitative evaluation of preoperative cerebral blood flow used in the Japanese EC-IC Bypass Trial (JET) study is useful for the prediction of postoperative cerebral infarction after cardiovascular surgery. First, patients were divided into two groups based on preoperative cerebral blood flow. In an evaluation using preoperative imaging, patients with good or mildly decreased preoperative cerebral blood flow, divided into clinical stage I or II by quantitative evaluation showed no postoperative cerebral infarction. However, 24% of patients with poor cerebral blood flow who were categorized as clinical stage II, experienced postoperative cerebral infarction. The incidence rate was not statistically significantly different when the groups were compared. Second, patients were divided into two groups based on the anatomical area of the brain affected corresponding to clinical stage II. Patients with a 10% and greater brain involvement had a significantly higher incidence of postoperative cerebral infarction (38%) compared to others (0%, p<0.01). This method may be useful for the prediction of postoperative cerebral infarction after cardiovascular surgery, but a further prospective study is needed. (This is a translation of J Jpn Coll Angiol 2017; 57: 125–133.)