Relationship between Extracorporeal Perfusion Pattern and Ischemic Brain Lesions

Abstract

Background: We aimed to investigate the post-procedure effect of pulsatile and non-pulsatile flow utilized in cardiopulmonary bypass on brain ischemia among patients undergoing coronary artery bypass grafting (CABG) surgery. Methods: A total of 80 patients undergoing elective CABG between April 2012 and January 2013 were separated into two groups. While pulsatile flow was implemented during cardiopulmonary bypass in 40 patients, non-pulsatile flow was used in the remaining 40 cases. Formation of new ischemic lesions in the brain was evaluated by Diffusion-weighted magnetic resonance imaging (DW-MRI), performed prior to and after the operation. Results: No statistically significant differences were found between the two groups in terms of demographic values and concomitant diseases. New focal lesions were detected in 7 of 40 patients subjected to pulsatile flow (17.5%) and in 4 of 40 cases subjected to non-pulsatile flow (10%). Although the number of new lesions detected on brain diffusion MRI in the non-pulsatile flow patient group was lower in terms of the number of patients and the number of lesions, no statistically significant differences were determined between the two groups. Conclusions: Magnetic resonance imaging evidence of brain injury were similar after pulsatil-pump and nonpulsatil-pump coronary artery bypass grafting surgery. Key words: Coronary artery bypass grafting, diffusion-weighted magnetic resonance imaging, pulsatile flow, nonpulsatile flow.