Brain swelling in first hour after coronary artery bypass surgery

Small ischemic brain lesions after cardiac valve replacement detected by diffusion-weighted magnetic resonance imaging: relation to neurocognitive function☆

“…There were 12 women and 18 men with a mean age of 64.9G9.8 years (range, 32-82) ( Table 1). Baseline examination (E1) was performed 6.1G4.3 days [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] before surgery. First postoperative examination (E2) was performed 5.0G1.4 days [3][4][5][6][7] after operation, usually on the day before discharge from hospital, and 4-month follow-up study was completed 111.3G30.4 days (80-202) postoperatively.…”

“…The pathogenesis of neurocognitive decline after heart surgery is still unknown, and many mechanisms have been postulated to be involved including cerebral embolization, hypoperfusion, edema, inflammation and metabolic disturbances [6][7][8]. Neuroimaging methods such as magnetic resonance imaging (MRI) have been increasingly employed in the study protocols after cardiac surgery since cerebral ischemia secondary to embolization, hypoperfusion, or a combination of these is considered to be a crucial pathophysiological factor underlying postoperative neurocognitive impairment [3].…”

Cerebral functions and metabolism after antegrade selective cerebral perfusion in aortic arch surgery

“…The mechanism of swelling is still not completely understood and a single aetiology can rarely be identified. However, various alterations related to CPB such as inflammatory response and plasmatic alterations such as the decrease of osmotic pressure can intervene in the pathogenesis [20,21]. The more extensive and intense brain swelling in the ASCP group may be related to longer times of CPB, such as lower systemic hypothermia and may disguise the metabolic alterations of the neuronal cells, which have been shown by PET.…”

Leukocyte filtration fails to limit functional neutrophil activity during cardiac surgery

“…Several authors have been able to show, that reperfusion injury to cardiac and pulmonary tissue is diminished by leukocyte filtration in the arterial line [5,6] or the venous line [7], and that leukocyte filtration in the blood cardioplegia delivery system can improve myocardial protection [8]. Despite these promising results, postoperative complications including systemic immune response syndrome (SIRS), myocardial and pulmonary reperfusion injury, and cerebral damage remain critical issues [1,2,9]. Other pathomechanisms such as aberrant function of clotting factors and platelets, complement factors or proteases may not be directly affected by leukocyte filters [reviewed in ref.…”