Neuropsychological impairment is a common complication of coronary artery bypass grafting (CABG). Although the cause of this cerebral injury is unclear, one of the frequently discussed pathophysiologic features in relation to conventional CABG with extracorporeal circulation (ECC) is focal dys-regulation caused by cerebral emboli. The advent of transcranial Doppler ultrasonography (TCD) provided a sensitive tool for the detection of emboli in the majority of patients during traditional CABG with ECC. Furthermore, several studies using TCD have reported a correlation between the count of high-intensity transient signals (HITS) and neuropsychological outcome. This suggests that surgical techniques should be improved to reduce the number of emboli. CABG without ECC (off-pump surgery) on a beating heart is an increasingly common procedure and an interesting alternative to traditional revascularization, […]

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