Background: Cardiopulmonary bypass (CPB) elicits a systemic inflammatory response that may result in disruption of the blood-brain barrier (BBB). This may one of the mechanisms accounting for postoperative neurological dysfunction. Disruption of the BBB can be currently identified by magnetic resonance imaging (MRI) reflected by postcontrast FLAIR images enhancement of the subarachnoid space. We aimed to determine whether (1) CPB elicits BBB disruption, (2) location of BBB injury and (3) reversibility of injury.
Methods: Ten consecutive patients referred to standard isolated on-pump coronary artery bypass grafting were assigned to undergo serial cerebral MRI evaluations. Designated MRI examinations were performed preoperatively, on postoperative days 1 and 5. Prior neurological events were among the exclusion criteria for enrollment.
Results and Conclusions: The results of 30 cerebral MRI examinations will be presented. Occurrence of postoperative BBB disruption, its location and duration will be discussed. The implications of these findings on postoperative neurological dysfunction will be elaborated and further protocols reviewed.
