ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Shragge, B.W.
Right arrow Articles by Doris, I.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Shragge, B.W.
Right arrow Articles by Doris, I.

Ann Thorac Surg 2000;70:1788
© 2000 The Society of Thoracic Surgeons

Scientific abstract

Neurocognitive outcomes after standard aortic versus femoral cannulation in coronary artery bypass graft surgery

B.W. Shragge, FRCS(C), P.L. Prior, PhD, H.C. Bauman, MHSc, E. Lonn, FRCP(C), F. Merali, MD, I. Doris, FRCP(C)

General Campus, HHSC, McMaster University, Hamilton, Ontario, Canada (ERB and informed consent obtained)

Background. Neurocognitive (NC) impairment or stroke, after coronary artery bypass grafting (CABG), may be associated with microembolization from ascending aortic and arch plaque. A pilot study of femoral (FemC) versus standard aortic cannulation (AoC) was undertaken to look for possible trends in NC outcome as a result of minimized plaque embolization with FemC.

Methods. Inclusion criteria were age 60 years and isolated CABG. Exclusion criteria were presence of carotid bruit and carotid duplex 70% stenosis, femoral arterial disease classification 20% stenosis in both arteries, or previous history of stroke or transient ischemic attack. Transesophageal echocardiogram was done before surgery. NC and quality of life measurements were done a mean of 2 weeks before and repeated a mean of 6 weeks after surgery.

Results. Five patients were initially randomized to FemC and 5 to AoC. One randomized to AoC died of multisystem failure and another, randomized to FemC, crossed over to AoC. Comparisons of the 5 patients in AoC versus the 4 in FemC show: age 68.6 versus 70.4 years (p = 0.64), maximum ascending aortic and arch plaque thickness 3.9 versus 4.9 mm (p = 0.48), pump time 65.8 versus 84.5 minutes (p = 0.05), and cross-clamp time 40.2 versus 56.8 minutes (p = 0.11). Overall, there was no consistent pattern of change in NC performance post- versus presurgery, nor between AoC and FemC. There were no complications with either technique. Increased age significantly predicted more decrement/less improvement in memory and verbal function. There is suggestive correlational evidence that maximum ascending aortic and arch plaque thickness predicted more decrement/less improvement in memory and learning functions.

Conclusions. There were trends toward associations between ascending aortic and arch plaque thickness and memory and learning functions that merit further investigation of cannulation techniques aimed at avoiding aortic plaque disruptions during surgery.




This article has been cited by other articles:


Home page
 J. Thorac. Cardiovasc. Surg.Home page
B. Ayyash, M. Tranquilli, and J. A. Elefteriades
Femoral artery cannulation for thoracic aortic surgery: Safe under transesophageal echocardiographic control
J. Thorac. Cardiovasc. Surg., December 1, 2011; 142(6): 1478 - 1481.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2000 by The Society of Thoracic Surgeons.