Does avoiding cardiopulmonary bypass for coronary artery bypass surgery result in less brain damage?
R. Peter Alston Department of Anaesthesia, Critical Care and Pain Medicine, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA UK E-mail: Peter.Alston{at}ed.ac.uk’ + u + ‘@’ + d + ”//–> Symptomatic benefit aside, coronary artery bypass grafting (CABG) surgery has prognostic advantages. Every day around the world, and despite the inexorable rise in the use of angioplasty, many thousands of patients still have patterns of coronary artery disease that require them to undergo CABG surgery to improve their longevity. However, this success of CABG surgery continues to be marred by a number of serious complications, in particular brain damage. The most overt manifestation of brain damage is stroke, which fortunately, given its impact on quality of life, occurs infrequently, in 3% of patients.1 If looked for prospectively, more subtle neurological deficits occur far more frequently, in 20% of patients.2 3 Cognitive decrements are another manifestation; 19 26% of pati
