Regional Cerebral Oxygen Desaturations in Coronary Artery Bypass Surgery: A Minimally Invasive Approach

Abstract

Cerebral oximetry has been shown to effectively identify declining regional cerebral oxygen saturations (rSO2) in coronary artery bypass graft (CABG) surgery. Prolonged intraoperative cerebral desaturations have been significantly associated with an increased risk of cognitive decline after CABG surgery. We compared conventional CABG to minimally invasive robotic coronary artery bypass surgery (r-CABG) using cerebral oximetry to determine the beneficial effects of the less invasive procedure. A retrospective study of 32 isolated CABG patients were treated for coronary artery disease (CAD) via conventional CABG (n=20) or r-CABG (n=12) with analysis of cerebral oximetry tracings and intraoperative data. Parameters, such as, blood loss, mean arterial pressure (MAP), partial pressure of carbon dioxide (PaCO2), cardiopulmonary bypass (CPB), and diabetes mellitus (DM) were analyzed against the area under the curve (AUC) from the cerebral oximetry tracing, an indicator of rSO2 desaturations. Many of these parameters showed statistical significance (p<0.05) between conventional CABG and r-CABG including a decreased mean AUC in the latter. In conclusion, minimally invasive r-CABG tends to show beneficial effects for patients by reducing the total mean AUC in comparison to conventional CABG, especially in the DM patient.