Comparing Minimal Invasive and Conventional Extracorporeal Circulation Effects on Brain Perfusion and Recovery in Coronary Artery Bypass Surgery

What this Trial Is About

Researchers are comparing two extracorporeal circulation techniquesminimal invasive extracorporeal circulation MiECC and conventional reservoir-based extracorporeal circulationin patients undergoing elective coronary artery bypass graft CABG surgery. The study focuses on how these methods affect cerebral perfusion and oxygenation, particularly by measuring changes in intracranial pressure using optic nerve sheath diameter ONSD via ultrasound, combined with near-infrared spectroscopy NIRS monitoring. This approach aims to provide better understanding of brain effects during cardiac surgery and improve perioperative neuromonitoring. The study will enroll 70 adult patients classified as ASA physical status II-III, scheduled for elective CABG surgery between February 2026 and February 2027. Patients will be assigned to receive either MiECC or conventional extracorporeal circulation based on clinical factors and surgeon choice. Anesthesia and cardiopulmonary bypass procedures will follow standardized protocols. ONSD measurements will be taken during the perioperative period by a blinded anesthesiologist using ultrasound, alongside continuous NIRS monitoring to assess cerebral oxygenation. Participants will be monitored during surgery and the immediate postoperative period. Data collected include demographic and clinical parameters, cerebral perfusion and oxygenation measurements, hemodynamic values, and postoperative outcomes such as extubation time, mechanical ventilation duration, and length of intensive care and hospital stays. Secondary outcomes also include the incidence of cerebrovascular events and correlations between ONSD and NIRS values. The total study duration extends through the hospital stay and up to 30 days post-surgery for some assessments.

Effects of Extracorporeal Circulation Techniques on Cerebral Perfusion in CABG Surgery