Asymmetric cerebral embolic load and postoperative cognitive dysfunction in cardiac surgery.
BACKGROUND
The aim of the study was to determine the effects of asymmetric cerebral embolic load on cognitive functions.


METHODS
Thirty-six open heart surgery (OH) and 26 coronary artery bypass grafting (CABG) patients were evaluated by neuropsychological and transcranial Doppler tests.


RESULTS
OH was associated with a significantly larger microembolic load in comparison to CABG. In OH patients, the microembolic load at the left middle cerebral artery correlated with a verbal memory decline, whereas the microembolic load at the right middle cerebral artery correlated with a nonverbal memory deficit. CABG patients also showed a postoperative verbal memory decline which correlated with cardiopulmonary bypass length but not with microembolic load.


CONCLUSIONS
Massive microembolic load during OH induces specific cognitive impairment in accordance to the brain region to which they are delivered. In atherosclerotic patients, the left temporal region is especially prone to perioperative ischemia.
Bokeriia
Leo A
LA
A N Bakulev Scientific Center of Cardiovascular Surgery, Russian Academy of Medical Sciences, Moscow, Russia.
Golukhova
Elena Z
EZ
Breskina
Nataliya Y
NY
Polunina
Anna G
AG
Davydov
Dmitry M
DM
Begachev
Alexey V
AV
Kazanovskaya
Svetlana N
SN
D000293:Adolescent; D000328:Adult; D000368:Aged; D001018:Aortic Diseases / Q000150:complications; D050197:Atherosclerosis / Q000150:complications; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D003072:Cognition Disorders / Q000209:etiology* / Q000503:physiopathology; D015331:Cohort Studies; D001026:Coronary Artery Bypass / Q000009:adverse effects; D005260:Female; D007839:Functional Laterality; D006331:Heart Diseases / Q000150:complications / Q000601:surgery; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000209:etiology; D020766:Intracranial Embolism / Q000000981:diagnostic imaging / Q000209:etiology*; D008297:Male; D008569:Memory Disorders / Q000209:etiology; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging; D013997:Time Factors; D017585:Ultrasonography, Doppler, Transcranial; D018084:Ultrasonography, Interventional