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From the Perioperative Cardiac Research Group (PECARG), Departments of Anesthesiology and *Cardiac Surgery, Centre Hospitalier de lUniversité de Montréal (CHUM), Hôtel-Dieu, Université de Montréal, Montréal, Québec, Canada
Address correspondence and reprint requests to Thomas M. Hemmerling, MD, DEAA, Centre Hospitalier de lUniversité de Montréal (CHUM), Hôtel-Dieu, Université de Montréal, 3840, rue Saint-Urbain, Montréal, Québec, Canada. Address e-mail to thomashemmerling{at}hotmail.com.
Bradycardia and hypotension are common during off-pump coronary artery bypass grafting (OPCAB). We present a case of possible reversible global cerebral hypoperfusion during distal grafting of the left circumflex coronary artery. The bispectral index (BIS) suddenly decreased from values of 4550 to 0 during distal grafting. Neurologic evaluation after immediate tracheal extubation in the operating room was normal and the 58 yr old patient did not suffer any neurologic sequelae. Postoperative recovery was uneventful and the patient was discharged 5 days after surgery. Cerebral hypoperfusion is a possible complication during OPCAB. BIS monitoring in OPCAB could be an indicator of cerebral hypoperfusion.
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