Magnetic resonance angiography in coronary artery bypass grafting.
An attempt was made to reduce the incidence of perioperative stroke by detecting cerebrovascular disease with preoperative head and neck magnetic resonance angiography and by selecting the coronary artery bypass grafting technique. This strategy was used in 268 patients with ischemic heart disease who had undergone both head and neck magnetic resonance angiography before elective coronary artery bypass in our hospital between May 1997 and April 2001. In patients with significant stenosis or obstruction detected by head and neck magnetic resonance angiography, the findings were evaluated and cerebral blood flow was examined using brain single-photon emission computed tomography. In those with a high risk of cerebrovascular ischemia, off-pump coronary artery bypass was performed to maintain cerebral blood flow. No stroke occurred during surgery, and hemodynamic cerebrovascular ischemia was prevented in all 268 patients. Postoperative stroke occurred in 3 patients (1.1%), but the incidence of perioperative stroke was reduced.
Ohuchi
Shingo
S
Department of Cardiovascular Surgery, Iwate Medical University Memorial Heart Center Morioka, Japan. gekai_ohuchi@hotmail.com
Kawazoe
Kohei
K
Izumoto
Hiroshi
H
Yoshioka
Kunihiro
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001157:Arterial Occlusive Diseases / Q000175:diagnosis*; D001488:Basilar Artery / Q000473:pathology; D002339:Carotid Arteries / Q000473:pathology; D002536:Cerebral Arteries / Q000473:pathology; D002560:Cerebrovascular Circulation; D001026:Coronary Artery Bypass / Q000379:methods*; D017558:Elective Surgical Procedures / Q000379:methods; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000601:surgery; D015588:Observer Variation; D011300:Preoperative Care / Q000379:methods; D012307:Risk Factors; D020521:Stroke / Q000517:prevention & control*; D015899:Tomography, Emission-Computed, Single-Photon; D014711:Vertebral Artery / Q000473:pathology