Effect of Carotid Stenosis Severity on Patterns of Brain Activity in Patients after Cardiac Surgery

Abstract

Background: The negative effects of high-grade carotid stenosis on the brain are widely known. However, there are still insufficient data on the brain state in patients with small carotid stenosis and after isolated or combined coronary and carotid surgery. This EEG-based study aimed to analyze the effect of carotid stenosis severity on associated brain activity changes and the neurophysiological test results in patients undergoing coronary artery bypass grafting (CABG) with or without carotid endarterectomy (CEA). Methods: One hundred and forty cardiac surgery patients underwent a clinical and neuropsychological examination and a multichannel EEG before surgery and 7–10 days after surgery. Results: The patients with CA stenoses of less than 50% demonstrated higher values of theta2- and alpha-rhythm power compared to the patients without CA stenoses both before and after CABG. In addition, the patients who underwent right-sided CABG+CEA had generalized EEG “slowdown” compared with isolated CABG and left-sided CABG+CEA patients. Conclusions: The on-pump cardiac surgery accompanied by specific re-arrangements of frequency–spatial patterns of electrical brain activity are dependent on the degree of carotid stenoses. The information obtained can be used to optimize the process of preoperative and postoperative management, as well as the search for neuroprotection and safe surgical strategies for this category of patients.

Keywords

• carotid stenosis
• brain electrical activity
• EEG
• postoperative cognitive dysfunction
• coronary artery bypass grafting
• carotid endarterectomy