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CARDIOVASCULAR
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Volume 3, 1998, No 3/4 |
Long-term Neuropsychologic
Function after Retrograde Cerebral Perfusion for Surgery of the
Aortic Arch
C. Baufreton, F.
Etcharry-Bouyx, D. Le Gall, P. Allain, J. B. Subayi, P. Binuani,
J. Emile, J. L. de Brux
Background: To evaluate the long term post-operative neuropsychologic function of patients undergoing surgery of the aortic arch using deep hypothermic circulatory arrest (DHCA) with retrograde cerebral perfusion (RCP).
Patients and methods: 13 patients have been operated on for aortic arch dissection (12 patients) or aneurysm (1 patient). There was one postoperative death and one late death, 3 years post-operatively. One patient could not participate in the study because he was hospitalized for a cholecystitis. Ten patients were evaluated 3 to 45 months post-operatively. The median duration of RCP in these patients was 68.5 min. (range:34-152); in 9 of them, the duration of RCP was longer than 45 minutes.
The following tests were performed: Mini Mental Status, the Purdue Pegboard, the Wechsler Memory Scale Revised, the Grober and Buschke, the Trail Making Test A and B, and the digit symbol of the Wechsler Adult Intelligence Scale - Revised. A non-parametric statistical analysis (p < 0.05 retained) was performed between the results of the psychometric tests and the duration of RCP, age of patients, education levels (years), and postoperative delay.
Results: The neuropsychologic evaluation was normal in 6 patients and pathologic in 2 patients. It was dissociated in 2 patients. No significant correlation was found between RCP duration or postoperative delay and results to the tests. Only increasing age and/or poor education level were significantly correlated to impaired neuropsychologic performance.
Conclusion: RCP allows extension of the duration of DHCA without being responsible for long term cognitive dysfunction in patients undergoing aortic arch surgery.
Key words: aortic arch surgery, deep hypothermic circulatory arrest, retrograde cerebral perfusion, neuropsychologic function, long-term postoperative outcome
Reference:
(CVE. 1998; 3 (3/4):
157-160)
Address for Correspondence:
Christophe Baufreton, M.D.,
Ph.D.
Department of Cardiovascular Surgery
University Hospital of Angers
4 rue Larrey
F-49033 Angers, Cedex 01
France
E-mail: ChBaufreton@chu-angers.fr
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