Perioperative cerebral infarct during cardiac surgery and changes in jugular venous O2 saturation and cerebral oximetry using near-infrared spectroscopy: A case report.
10.4097/kjae.2009.56.1.102
- Author:
Eun Su CHOI
1
;
Jae Hun KIM
;
Nam Su GIL
;
Jong Hwan LEE
;
Yun Seok JEON
;
Kyung Hwan KIM
;
Jae Hyon BAHK
Author Information
1. Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Korea. jeonyunseok@gmail.com
- Publication Type:Case Report
- Keywords:
Aortic valve replacement;
Cardiopulmonary bypass;
Cerebral infarct;
Cerebral oximetry;
Neurologic complication;
SjvO2
- MeSH:
Anesthesia;
Aorta;
Aortic Valve;
Cardiopulmonary Bypass;
Catheters;
Cerebrum;
Edema;
Embolism, Air;
Humans;
Oximetry;
Perioperative Period;
Seizures;
Spectroscopy, Near-Infrared;
Thoracic Surgery
- From:Korean Journal of Anesthesiology
2009;56(1):102-105
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Despite reductions in surgical mortality, neurologic sequelae remain a devastating complication after cardiac surgery with cardiopulmonary bypass. Neurologic complications may be induced by a massive air embolism during cardiopulmonary bypass, even with extensive monitoring. This report describes a patient who had a fatal cerebral infarct during aortic valve and ascending aorta replacement surgery. We monitored jugular venous O2 saturation (SjvO2) and cerebral oximetry using near-infrared spectroscopy in the perioperative period. The operation and anesthesia were uneventful until the deep hypothermic total arrest for the replacement of the ascending aorta. However, restarting the cardiopulmonary bypass after deep hypothermic total arrest produced a brief (less than 10 seconds) but large amount of air in the root cannula. At this time, although cerebral oximetry did not show any changes, the SjvO2 decreased to 21% for about 3 minutes and then normalized. At 8 hours after surgery, the patient showed seizures and severe edema in both cerebral hemispheres on the MRI. The patient died 21 days after surgery.
