Is there a relationship between systemic perfusion temperature during coronary artery bypass grafting and extent of intraoperative ischemic central nervous system injury?

Objective: This study was designed to compare the volume of cerebral infarc tion in patients operated on under either hypothermic or tepid/normothermic perfusion for coronary revascularization. Methods: A randomized trial with preoperative, postoperative, and late neurologic evaluation was conducted in patients undergoing coronary revascularization having either hypothermic or tepid/normothermic perfusion for coronary revascularization, The goal w as to determine whether perfusion temperature correlated with neurologic dy sfunction associated with coronary artery bypass. Results: Twelve intraoper ative ischemic strokes occurred during coronary revascularization in a seri es of 291. patients. Six of these were in the group receiving hypothermic p erfusion and 6 in groups receiving the tepid/normothermic perfusion. Measur ing the infarct volume documented that 3 of the strokes in each group resul ted in minor or small infarcts and 3 in each group were significant, major strokes. The volume of infarction, whether including all 6 patients in each group or only those with major strokes, was no different between the hypot hermic and the tepid/normothermic groups. Conclusions: In this series of 29 1 patients randomized to perfusion temperature, we observed no relationship between the size of a cerebral ischemic infarct and the perfusate temperat ure during coronary revascularization.