Neurocognitive functions after beating heart mitral valve replacement without cross-clamping the aorta.
OBJECTIVE
Although neurologic outcome after cardiac surgery is well-established, neurocognitive functions after beating heart mitral valve replacement still needs to be elucidated. The aim of this study was to compare preoperative and postoperative neurocognitive functions in patients who underwent beating heart mitral valve replacement on cardiopulmonary bypass without cross-clamping the aorta.


METHODS
The prospective study included 25 consecutive patients who underwent mitral valve replacement. The operations were carried out on a beating heart method using normothermic cardiopulmonary bypass without cross-clamping the aorta. All patients were evaluated preoperatively (E1) and postoperatively (at sixth day [E2] and second month [E3]) for neurocognitive functions.


RESULTS
Neurologic deficit was not observed in the postoperative period. Comparison of the neurocognitive test results, between the preoperative and postoperative assessment for both hemispheric cognitive functions, demonstrated that no deterioration occurred. In the three subsets of left hemispheric cognitive function test evaluation, total verbal learning, delayed recall, and recognition, significant improvements were detected at the postoperative second month (E3) compared to the preoperative results (p = 0.005, 0.01, and 0.047, respectively). Immediate recall and retention were significantly improved within the first postoperative week (E2) when compared to the preoperative results (p = 0.05 and 0.05, respectively).


CONCLUSIONS
The technique of mitral valve replacement with normothermic cardiopulmonary bypass without cross-clamping of the aorta may be safely used for majority of patients requiring mitral valve replacement without causing deterioration in neurocognitive functions.
Cicekcioglu
Ferit
F
Cardiovascular Surgery Clinic, Turkiye Yuksek Ihtisas Hospital, Ankara, Turkey. fehmiege@yahoo.com
Ozen
Anil
A
Tuluce
Hicran
H
Tutun
Ufuk
U
Parlar
Ali Ihsan
AI
Kervan
Umit
U
Karakas
Sirel
S
Katircioglu
Salih Fehmi
SF
D000328:Adult; D001007:Anxiety / Q000209:etiology; D001011:Aorta / Q000601:surgery*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D003071:Cognition; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D003863:Depression / Q000209:etiology; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000379:methods* / Q000523:psychology*; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000209:etiology; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D009483:Neuropsychological Tests; D011184:Postoperative Period; D011300:Preoperative Care; D011446:Prospective Studies; D011594:Psychometrics