| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 2002;74:407-412
© 2002 The Society of Thoracic Surgeons
a Department of Cardio-Thoracic Surgery, Vienna General Hospital, University of Vienna, Vienna, Austria
b Department of Internal Medicine, Vienna General Hospital, University of Vienna, Vienna, Austria
Accepted for publication March 28, 2002.
* Address reprint requests to Dr Grimm, Department of Cardio-Thoracic Surgery, University of Vienna, Waehriger Guertel 18-20, A-1090 Vienna, Austria
e-mail: michael.grimm{at}akh-wien.ac.at
Background. Impairment of cognitive brain function after coronary artery bypass grafting (CABG) is well known. In contrast the potential neurocognitive damage related to aortic valve replacement (AVR) is uncertain.
Methods. In this contemporary case-matched control study we followed 30 patients (mean age 70 years) receiving isolated AVR with a biological prosthesis. A cohort of sex-and age-matched patients (n = 30, mean age 70 years) receiving CABG with cardiopulmonary bypass served as controls. Cognitive brain function was measured by means of auditory evoked P300 potentials (peak latencies, ms) before the operation and 7 days and 4 months after the operation. Additionally, two standard psychometric tests (Mini-Mental State Examination and the Trailmaking Test A) were performed.
Results. In preoperative measures there was no difference between patients undergoing AVR and patients undergoing CABG (AVR 378 ± 37 ms, CABG 374 ± 32 ms, p = 0.629). One week after surgery P300 peak latencies were prolonged (impaired) in both groups compared with preoperative values (AVR 405 ± 43 ms, p = 0.001; CABG 398 ± 44 ms, p = 0.004). At this point of follow-up there was no difference between the groups (p = 0.607). Finally, 4 months after surgery P300 auditory evoked potentials returned to normal in the CABG group (380 ± 24 ms, p = 0.940) while in contrast in the valve group they continued to become prolonged (worsened) compared with preoperative values (410 ± 47 ms, p = 0.005). At this time of follow-up P300 peak latencies were prolonged in AVR patients as compared with CABG patients (p = 0.032). The Trailmaking Test A and Mini-Mental State Examination failed to discriminate any difference.
Conclusions. Four-month impairment of cognitive brain function is more pronounced in patients undergoing biological AVR as compared with age-matched control patients undergoing CABG. Further studies are needed to clarify the potential pathologic mechanisms causing an ongoing cognitive impairment in patients with biological aortic valve prostheses.
This article has been cited by other articles:
|
|
 |
|
  T. Feldman and M. B. Leon Prospects for Percutaneous Valve Therapies Circulation, December 11, 2007; 116(24): 2866 - 2877. [Full Text] [PDF]
|
|
|
|
 |
|
 D. Zimpfer, M. Czerny, P. Schuch, R. Fakin, C. Madl, E. Wolner, and M. Grimm Long-Term Neurocognitive Function After Mechanical Aortic Valve Replacement Ann. Thorac. Surg., January 1, 2006; 81(1): 29 - 33. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. C. Knipp, N. Matatko, M. Schlamann, H. Wilhelm, M. Thielmann, M. Forsting, H. C. Diener, and H. Jakob Small ischemic brain lesions after cardiac valve replacement detected by diffusion-weighted magnetic resonance imaging: relation to neurocognitive function Eur. J. Cardiothorac. Surg., July 1, 2005; 28(1): 88 - 96. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Zimpfer, M. Czerny, F. Vogt, P. Schuch, L. Kramer, E. Wolner, and M. Grimm Neurocognitive deficit following coronary artery bypass grafting: a prospective study of surgical patients and nonsurgical controls Ann. Thorac. Surg., August 1, 2004; 78(2): 513 - 518. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Grimm and D. Zimpfer Reply to Jahangiri and Motallebzadeh Eur. J. Cardiothorac. Surg., October 1, 2003; 24(4): 666 - 666. [Full Text] [PDF]
|
|
|
|
|
|
D. Zimpfer, J. Kilo, M. Czerny, M.-T. Kasimir, C. Madl, E. Bauer, E. Wolner, and M. Grimm Neurocognitive deficit following aortic valve replacement with biological/mechanical prosthesis Eur. J. Cardiothorac. Surg., April 1, 2003; 23(4): 544 - 551. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Grimm, D. Zimpfer, M. Czerny, J. Kilo, M.-T. Kasimir, L. Kramer, A. Krokovay, and E. Wolner Neurocognitive deficit following mitral valve surgery Eur. J. Cardiothorac. Surg., March 1, 2003; 23(3): 265 - 271. [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 |
