Is it better to shine a light, or rather to curse the darkness? Cerebral near-infrared spectroscopy and cardiac surgery

摘要

Cerebral perfusion and good neurological outcome appear most obviously at risk during operations on the aortic arch. However, it is also evident that from a numerical standpoint, otherwise uncomplicated coronary artery bypass grafting (CABG) accounts for the greatest number of perioperative strokes, as shown in a review of 7839 patients in which it was determined that the overall incidence of clinical stroke immediately apparent at extubation was 1.4% and that in addition to severe aortic calcification, cardiopulmonary bypass (CPB) time was also an independent risk factor [1]. Similarly, in a previous study of 13 897 CABG patients, it was also noted that the duration of CPB increased the risk of hypoperfusion strokes and that 'nearly 75% of all strokes occurred among the 90% of patients at low or medium preoperative risk' [2].