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Ann Thorac Surg 1999;68:1458
© 1999 The Society of Thoracic Surgeons

Supplement: Outcomes ’99: Scientific Abstracts

Regional abnormalities of cerebral metabolism with cardiopulmonary bypass using 18FDG-PET

D.N. Harris, MDa, S. Afolami, FRCAa, C. Barnett, DcRa, R. Meyers, PhDa

a Hammersmith Hospital, London, England, United Kingdom

Background: During rewarming from hypothermic bypass, there is jugular bulb desaturation suggestive of cerebral ischemia, which might be associated with the high incidence of neuropsychological defects after cardiac operation [1]. However this is a global measurement, and there are no data on regional cerebral metabolism. 18FDG-PET has been used to study cerebral metabolism in animal studies [2], and human volunteers [3], but this is the first data in patients during cardiac operation.

Methods: Six male patients aged 52–74 (mean 64) were studied. Control FDG scans were acquired the day before operation. For the operative scan, FDG was injected 5 minutes after bypass, and the patient taken to the PET unit immediately after surgery; scanning began 60 minutes after injection. Images were normalized for injected dose and blood glucose, and a difference image was generated. Global and regional change scans were inspected visually.

Results: All 6 patients showed marked reduction in cerebral metabolism on the operative scan. There were clear regional differences, with a relative increase in metabolism in the cingulate gyrus.

Conclusions: Cerebral metabolism is reduced globally after hypothermic cardiopulmonary bypass, but this could be due to anesthesia. However, the regional changes suggest that rewarming is indeed associated with abnormalities of cerebral metabolism.

References

  1. J Card Surg 1995;10(4 Suppl):503–8.
  2. J Thorac Cardiovasc Surg 1998;116:503–10.
  3. Anesthesiology 1997;86:549–57.




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