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Perfusion, Vol. 13, No. 5, 328-333 (1998)
DOI: 10.1177/026765919801300508

Magnetic resonance spectroscopy of high-energy phosphates and lactate immediately after coronary artery bypass surgery

D NF Harris

Department of Anaesthesia, Imperial College School of Medicine, Hammersmith Hospital, London, dharris{at}rpms.ac.uk

J A Wilson

Department of Anaesthesia, Imperial College School of Medicine, Hammersmith Hospital, London

S D Taylor-Robinson

Department of Gastroenterology and Robert Steiner Magnetic Resonance Unit, Imperial College School of Medicine, Hammersmith Hospital, London

K M Taylor

Department of Cardiothoracic Surgery, Imperial College School of Medicine, Hammersmith Hospital, London

Hypothermic cardiopulmonary bypass (CPB) is associated with a high incidence of neuropsychological defects, marked cerebral swelling immediately after surgery and jugular bulb desaturation during rewarming. This suggests cerebral ischaemia may occur, but evidence is indirect. We studied four patients with 31P magnetic resonance spectroscopy (MRS) and four with 1H MRS before and immediately after coronary surgery. There was no visible lactate in 1H MR spectra. In 31P MR spectra, the ratio of phosphocreatine to adenosine triphosphate was maintained (before: 2.13 ± 0.86 vs after: 2.57 ± 1.31; mean ± 1 SD) and there was no intracellular acidosis (intracellular pH: 7.1 ± 0.04 vs 7.16 ± 0.08), while phosphocreatine/inorganic phosphate was increased immediately after the operation (2.92 ± 0.37 vs 6.39 ± 2.67, p = 0.03). This suggests rebound replacement of energy stores following recovery from temporary cerebral ischaemia during CPB: intra-operative studies would be needed to test this hypothesis further.


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