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Ann Thorac Surg 1992;53:807-812
© 1992 The Society of Thoracic Surgeons

Articles

Magnetic resonance imaging of the brain before and after open heart operations

Mikael Sellman, MD*, Tomas Hindmarsh, MD, PhD, Torbjörn Ivert, MD, PhD, Bjarne K.H. Semb, MD

Departments of Cardiothoracic Surgery and Diagnostic Radiology, Karolinska Institute, Stockholm, Sweden

Accepted for publication October 10, 1991.

* Address reprint requests to Dr Sellman, Cardiothoracic Surgical Clinic, Karolinska Hospital, S-104 01 Stockholm, Sweden.

Magnetic resonance imaging of the brain was performed in 29 adult male patients before and 1 week after elective coronary artery bypass grafting to study the cerebral effect of cardiopulmonary bypass. The mean age of the patients was 60 years (range, 45 to 69 years). During cardiopulmonary bypass, either a bubble oxygenator without an arterial line filter (n = 9), a bubble oxygenator with a depth adsorption filter (n = 10), or a flat-sheet membrane oxygenator without a filter (n = 10) was used. The mean bypass time was 88 minutes (standard deviation, 31 minutes) and did not differ significantly between the three groups. Preoperative magnetic resonance imaging revealed high signal intensity foci on T2-weighted images (white matter abnormalities) in 17 (59%; 95% confidence limits, 39% to 76%) of the 29 patients, all of which were nonspecific and of the common type considered to be related to aging, and all were unchanged at the postoperative examination. Preoperative and postoperative frontal horn indices, bicaudate diameters, and third ventricle widths did not differ significantly regardless of oxygenator type or whether or not an arterial line filter was used during cardiopulmonary bypass. Two patients (7%; 95% confidence limits, 1% to 23%), both receiving bubble oxygenation (1 without a filter and 1 with an arterial line filter) sustained a cerebral infarction during cardiopulmonary bypass.




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