Comparative study on cerebral injury after open heart surgery in patients with congenital and rheumatic heart disease.
OBJECTIVE
To comparatively study the different effects of open heart surgery on brain tissues of patients with congenital and rheumatic heart disease.


METHODS
Forty patients with congenital heart disease (CHD, CHD group, n = 20) or rheumatic heart disease (RHD, RHD group, n = 20) underwent on-pump (cardiopulmonary bypass, CPB) heart-beating open heart surgery. Blood samples before CPB, and 20 minutes, 1 hour, 24 hours and 7 days after CPB were collected, and the levels of neuron-specific enolase (NSE) and protein S-100b in the plasma were determined with enzyme-linked immunoadsorbent assay (ELISA), respectively. All the patients were examined with electroencephalogram (EEG) before and 1 week after operation. The changes of NSE, S-100b and EEG compared to verify the difference of postoperative cerebral injury between CHD cases and RHD cases.


RESULTS
The plasma level of S-100b increased significantly 20 minutes after CPB and was still higher than the preoperative level at 24 hours after operation in both groups (P < 0.01). The plasma level of NSE increased more significantly in the CHD group than in the RHD group 20 minutes after CPB and it returned to the normal level 24 hours after CPB in the CHD group but remained at a high level in the RHD group (P < 0.01). The levels of NSE and S-100b returned to the normal levels on the 7th day after CPB. Abnormal EEG was found in 75% of the patients in the CHD group and 60% in the RHD group.


CONCLUSIONS
On-pump heart-beating open heart surgery can cause certain cerebral injury in the patients with CHD or RHD. The injury was more severe and recovered more quickly in the CHD group than in the RHD group.
Wang
Yong
Y
Department of Cardiovascular Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing, China. wy003236@hotmail.com
Xiao
Ying-Bin
YB
Chen
Lin
L
Zhong
Qian-Jin
QJ
Wang
Xue-Feng
XF
D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D004569:Electroencephalography; D005260:Female; D006330:Heart Defects, Congenital / Q000097:blood / Q000601:surgery*; D006801:Humans; D008297:Male; D009414:Nerve Growth Factors / Q000097:blood; D010751:Phosphopyruvate Hydratase / Q000097:blood; D011183:Postoperative Complications / Q000209:etiology*; D012214:Rheumatic Heart Disease / Q000097:blood / Q000601:surgery*; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins / Q000097:blood
D009414:Nerve Growth Factors; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins; D010751:Phosphopyruvate Hydratase