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Editorials |

Is Off-Pump Cardiac Surgery Better for the Brain?

Song Wan, MD, PhD; Anthony P. C. Yim, DM, FCCP
Author and Funding Information

Affiliations: Shatin, Hong Kong, China 
 ,  Dr. Yim is Chief, Division of Cardiothoracic Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital. Dr Wan is a cardiac surgeon at the Prince of Wales Hospital.

Correspondence to: Anthony P. C. Yim, DM, FCCP, Chief, Division of Cardiothoracic Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China; e-mail: yimap@cuhk.edu.hk



Chest. 2001;119(1):1. doi:10.1378/chest.119.1.1
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Despite the many advances made in cardiac surgery over the past decades, postoperative brain injury remains a dreaded complication that could result in excess mortality and medical resource utilization. Neurologic impairment following cardiac surgery could manifest as a spectrum, from a serious stroke (type I) to subtle cognitive impairment (type II). From the standpoint of prevention, embolization and perioperative cerebral hypoperfusion are the two commonest causes of neuropsychologic deterioration following coronary artery bypass grafting (CABG).1 In this issue of CHEST (see page 25), Bowles and colleagues suggest that avoiding the use of cardiopulmonary bypass (CPB) could lead to reduced cerebral microemboli during coronary revascularization, as measured by intraoperative transcranial Doppler ultrasonography. Considering that CABG represents more than half the workload in adult cardiac surgery worldwide, cerebral protection is an important issue that affects our decision-making process and impacts on our daily practice.

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