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Ann Thorac Surg 2002;73:S367
© 2002 The Society of Thoracic Surgeons

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SUPPLEMENT: OUTCOMES 2001: SCIENTIFIC ABSTRACTS

Magnetic resonance imaging and cognitive changes before and after coronary artery bypass graft

^a The Johns Hopkins Hospital, Baltimore, Maryland, USA

Introduction. Conventional magnetic resonance imaging and angiography (MRI/MRA), MR perfusion (MRP), as well as the availability of new technology, diffusion weighted imaging (DWI), has allowed us to examine the role of baseline cerebrovascular disease and acute infarction on cognitive changes after surgery.

Methods. The study had Internal Review Board approval and patients completed informed consent. Patients completed preoperative MRI/MRA, DWI, and MRP, as well as the trail making test (TMT). Patients were to have the same protocol on postoperative days 3 to 5.

Results. Thirteen patients completed all preoperative scans. MRI/MRA revealed the following: abnormalities in 9/13 (69%): old lesions in 4/13, periventricular white matter changes in 7/13, and intravascular stenosis in 4/13. Only 1 (8%) had an acute lesion identified on DWI preoperatively. Of the 7 patients who completed the postoperative scans, only 1 had an acute lesion not present preoperatively on DWI. MRP showed no perfusion changes in these 7 patients. Six patients who had a preoperative MRI/MRA abnormality completed the TMT both pre- and postoperative. All 6 patients declined on the TMT (mean decline = 49 seconds). Three patients had no preoperative MRI/MRA abnormalities, and all 3 improved on the TMT. (p < 0.003).

Conclusions. Brain abnormalities are common before surgery in patients with diagnosed coronary disease. Few have acute lesions (on DWI) preoperatively. Patients with abnormal MRI/MRA preoperatively may be more likely to decline on the TMT, a test of psychomotor slowing.

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This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Grega, M.A. Articles by McKhann, G.M. Search for Related Content PubMed Articles by Grega, M.A. Articles by McKhann, G.M. Related Collections Coronary disease