TITLE

Prediction of cognitive dysfunction and patients’ outcome following valvular heart surgery and the role of cerebral oximetry

AUTHOR(S)
Hong, Seong Wook; Shim, Jae Kwang; Choi, Yong Seon; Kim, Dae Hee; Chang, Byung Chul; Kwak, Young Lan
PUB. DATE
April 2008
SOURCE
European Journal of Cardio-Thoracic Surgery;Apr2008, Vol. 33 Issue 4, p560
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Abstract: Objective: Postoperative cognitive dysfunction (POCD) commonly develops after cardiac surgery affecting patients’ outcome. Cerebral oximetry noninvasively measures regional cerebral oxygen saturation (rSO2) and significant correlation has been reported between intraoperative cerebral desaturation and POCD, as well as patients’ outcome following coronary artery bypass grafting. However, evidence is limited in valvular heart surgery (VHS). We investigated the relationship of intraoperative rSO2 values with POCD and length of postoperative hospitalization in patients undergoing VHS. Methods: One hundred patients undergoing elective VHS were enrolled. Neurocognitive evaluation was performed with Mini-Mental State Examination, Trail-Making Test (Part A), and Grooved Pegboard Test at 1 day before and 7th day after surgery. During surgery, rSO2 was continuously monitored and the incidence and duration of decrease in rSO2 values for five consecutive minutes were recorded as follows; (1) decrease in absolute rSO2 values to less than 50%, (2) 40%, and (3) a 20% decrease compared to baseline value. Results: Twenty-three patients (23%) demonstrated POCD. We could not observe any significant differences in either the incidence or duration of decrease in rSO2 values between patients with and without POCD. Low education level and higher baseline temperature had significant correlation with POCD. Patients with cerebral desaturation required significantly longer postoperative hospitalization. Conclusion: In patients undergoing VHS, POCD could not be predicted with cerebral oximetry. However, patients with intraoperative cerebral desaturation required significantly longer postoperative hospitalization and cerebral oximetry appears to be promising in terms of monitoring the brain as the index organ for systemic perfusion and improving patients’ outcome.
ACCESSION #
31304672

 

Related Articles

  • Preoperative statin use and in-hospital outcomes following heart surgery in patients with unstable angina. Ali, Imtiaz S.; Buth, Karen J. // European Journal of Cardio-Thoracic Surgery;Jun2005, Vol. 27 Issue 6, p1051 

    Abstract: Objective: Unstable angina (UA) is characterized by a state of coronary artery vascular inflammation and endothelial dysfunction. Statins mitigate inflammation and endothelial dysfunction and decrease mortality associated with percutaneous interventions for UA. We determined whether...

  • The assessment of complexity in congenital cardiac surgery based on objective data. Clarke, David R.; Lacour-Gayet, Francois; Jacobs, Jeffrey Phillip; Jacobs, Marshall L.; Maruszewski, Bohdan; Pizarro, Christian; Edwards, Fred H.; Mavroudis, Constantine // Cardiology in the Young;Dec2008 Supplement, Vol. 18 Issue S2, p169 

    When designed in 2000, the Aristotle Complexity Score was entirely based on subjective probability. This approach, based on the opinion of experts, was considered a good solution due to the limited amount of data available. In 2008, the next generation of the complexity score will be based on...

  • Retraction Note: Influence of two different volume replacement regimens on renal function in elderly patients undergoing cardiac surgery: comparison of a new starch preparation with gelatin. Boldt, Joachim; Brenner, Thorsten; Lehmann, Andreas; Lang, Johannes; Kumle, Bernhard; Werling, Christiane // Intensive Care Medicine;Jul2011, Vol. 37 Issue 7, p1230 

    The article informs that the article "Influence of two different volume replacement regimens on renal function in elderly patients undergoing cardiac surgery: comparison of a new starch preparation with gelatin," in a previous issue, has been retracted.

  • Retraction Note: Prophylactic use of the phospodiesterase III inhibitor enoximone in elderly cardiac surgery patients: effect on hemodynamics, inflammation, and markers of organ function. Boldt, Joachim; Brosch, Christian; Suttner, Stefan; Piper, Sven N.; Lehmann, Andreas; Werling, Christiane // Intensive Care Medicine;Jul2011, Vol. 37 Issue 7, p1229 

    The article informs that the article "Prophylactic use of the phospodiesterase III inhibitor enoximone in elderly cardiac surgery patients: effect on hemodynamics, inflammation, and markers of organ function," published in a previous issue, has been retracted.

  • Retraction Note: The influence of a balanced volume replacement concept on inflammation, endothelial activation, and kidney integrity in elderly cardiac surgery patients. Boldt, Joachim; Suttner, Stephan; Brosch, Christian; Lehmann, Andreas; Röhm, Kerstin; Mengistu, Andinet // Intensive Care Medicine;Jul2011, Vol. 37 Issue 7, p1233 

    The article informs that the article "The influence of a balanced volume replacement concept on inflammation, endothelial activation, and kidney integrity in elderly cardiac surgery patients," published in a previous issue, has been retracted.

  • The Change-Up. Sabrin, George J. // Cortlandt Forum;04/25/99, Vol. 12 Issue 4, p67 

    Describes the author's encounter with a lawyer patient who had a heart surgery. Patient's request for the author to issue a note certifying that the lawyer is fit to have sex.

  • Is simultaneous splenectomy an additive risk factor in surgical treatment for active endocarditis? Akhyari, Payam; Mehrabi, Arianeb; Adhiwana, Angelina; Kamiya, Hiroyuki; Nimptsch, Katharina; Minol, Jan-Philipp; Tochtermann, Ursel; Godehardt, Erhrad; Weitz, Jürgen; Lichtenberg, Artur; Karck, Matthias; Ruhparwar, Arjang // Langenbeck's Archives of Surgery;Dec2012, Vol. 397 Issue 8, p1261 

    Purpose: Splenic abscess formation is a serious complication in the setting of active endocarditis, and splenectomy is recommended. However, the optimal timing for splenectomy is yet undetermined. The purpose of this study was to evaluate the role of a one-stage splenectomy and valve surgery for...

  • Infective endocarditis in Europe: lessons from the Euro heart survey. Tornos, P.; Jung, B.; Permanyer-Miralda, G.; Baron, G.; Delahaye, F.; Gohlke-Bärwolf, Ch.; Butchart, E. G.; Ravaud, P.; Vahanian, A. // Heart;May2005, Vol. 91 Issue 5, p571 

    Objectives: To describe the characteristics, treatment, and outcomes of active infective endocarditis (IE) in Europe. Design: Prospective survey of medical practices in Europe. Setting: 92 centres from 25 countries. Patients: The EHS (Euro heart survey) on valvar heart disease (VHD) enrolled...

  • Why are heart operations postponed?  // Journal of Cardiothoracic Surgery;2011, Vol. 6 Issue 1, p106 

    The article presents a study to investigate the reasons, which lead to postponement of cardiac operations. In the study, patients who had elective heart surgery during the 4-year period 2007-2010 were included. In the examined period 94 patients had their elective heart operation postponed. All...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics