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Ann Thorac Surg 2004;77:1635
© 2004 The Society of Thoracic Surgeons

Invited commentary

David L. Reich, MD

Department of Anesthesiology Mount Sinai School of Medicine, One Gustave L. Levy Place Box 1010 New York, NY 10029, USA

Suzan Uysal, PhD

Department of Anesthesiology Mount Sinai School of Medicine, One Gustave L. Levy Place Box 1010 New York, NY, 10029, USA

e-mail: david.reich@mssm.edu
e-mail: suzan.uysal@mssm.edu

The first 20% of the full text of this article appears below.

We are very pleased that Miyairi and colleagues have performed this prospective study of a large clinical cohort using psychometric testing. The conclusion that long periods of retrograde cerebral perfusion (RCP) were associated with negative outcomes is an important clinical finding that has implications for future approaches to cerebral protection in complex thoracic aortic repairs. Our comments are intended to place this study in context.

A limitation of the study is the authors' choice of the WAIS-R as a neurocognitive outcome measure. The WAIS-R is a psychometric "intelligence" test that was originally developed as the Wechsler-Bellevue scale in 1939, prior to current conceptualizations of the neural basis of cognition. It . . . [Full Text of this Article]






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