Brain microemboli during cardiac surgery or aortography.

Abstract:

:We have observed many focal dilatations or very small aneurysms in terminal arterioles and capillaries of 4 of 5 patients and 6 dogs who had recently undergone cardiopulmonary bypass. A smaller number of sausagelike dilatations distended medium-sized arterioles. Two other patients had a small number of the same microvascular changes following proximal aortography. Thirty-four patients and 6 dogs not undergoing cardiopulmonary bypass had none. (A 35th patient who had not undergone cardiopulmonary bypass or aortography showed a small number of dilatations; mediastinal air was a suggested source.) Some of the dilatations exhibited various forms of birefringence. Because most of the dilatations appear empty, we speculate that they are the sites of gas bubbles or fat emboli that have been removed by the solvents used in processing. These microvascular events, occurring only in conjunction with major arterial interventions, may be the anatomical correlate of the neurological deficits or moderate to severe intellectual dysfunction seen in at least 24% of patients after cardiac surgical procedures assisted by cardiopulmonary bypass.

journal_name

Ann Neurol

journal_title

Annals of neurology

authors

Moody DM,Bell MA,Challa VR,Johnston WE,Prough DS

doi

10.1002/ana.410280403

subject

Has Abstract

pub_date

1990-10-01 00:00:00

pages

477-86

issue

4

eissn

0364-5134

issn

1531-8249

journal_volume

28

pub_type

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