The role of gas microembolism from the heart-lung machine in microembolization of cerebral blood flow during reconstructive operations on the aorta

• Aleksandr V. Panov
• Lokshin L.S.
• Gubko A.V.

Abstract

According to the majority of the  most authors one of the main causes of neurological complications after operations performed under EC conditions is cerebral gas embolism with subsequent impairment of cerebral perfusion and damage to the nervous tissue.

Aim. To evaluate the dynamics of the microembolic signal in the middle cerebral arteries and gas microembolism from the heart-lung machine and determine the correlation between these indicators.

Material and methods. The study included 49 patients operated on for aortic dissection and aneurysm. Exclusion criteria were a history of acute cerebrovascular accident, traumatic brain injury and cognitive impairment, and lack of access to both middle cerebral arteries for insonation through the temporal fenestrae.

Results. Spearman’s rank correlation coefficient between the number of registered gas microemboli in the arterial line of the heart-lung machine and the number of microembolic signals of gas origin was 0.767 (p<0.05).

Conclusion. The amount of microembolic signal of gas origin in the middle cerebral arteries has a direct correlation with the volume of gas microembolism from the heart-lung machine.

Keywords:gas microembolism; artificial circulation; extracorporeal circuit; circulatory arrest; antegrade cerebral perfusion; microembolic signal; transcranial Doppler sonography

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