title: Comparison of neurocognitive functions after beating-heart mitral valve replacement without aorta cross-clamping and after standard mitral valve replacement with cardioplegic arrest.
abstract: BACKGROUND
  The aim of this study was to compare the postoperative long-term neurocognitive functions of patients who under-went beating-heart mitral valve replacement on cardiopulmonary bypass (CPB) without aorta cross-clamping with those of patients who underwent mitral valve replacement via the classic method.
  
  
  METHODS
  The study group included 25 randomly selected patients who underwent beating-heart mitral valve surgery. During the same period, 25 patients were randomly selected as controls to undergo mitral valve replacement procedures via the standard ascending aorta-cannulation technique. The clinical and postoperative (2 months) neurocognitive functional data of both groups were compared.
  
  
  RESULTS
  Neurologic deficit was observed in neither group during the postoperative period. There were no statistically significant differences between the control and the study groups with respect to Hospital Anxiety and Depression Scale (HADS) results (HADS: anxiety, P = .653; HADS: depression, P = .225), in the right hemispheric cognitive function test results (Raven's Standard Progressive Matrices [RSPM] and Line Orientation Test [LOT] tests: RSPM, P = .189), and in the left hemispheric cognitive function test results (the Ray Auditory Verbal Learning [RAVL] and Stroop Color-Word Test [SCWT] tests: SCWT 1 time, P = .300; SCWT 2 time, P = .679; SCWT 3 time, P = .336; SCWT 4 time, P = .852; SCWT 5 time, P = .416; RAVL total verbal learning, P = .167; RAVL immediate recall, P = .791; RAVL distraction trial, P = .199; RAVL retention, P = .174; RAVL delayed recall, P = .111; RAVL recognition, P = .282; SCWT 4 mistake, P = .306; SCWT 4 reform, P = .066; SCWT 5 mistake, P = .236; SCWT 5 reform, P = .301).
  
  
  CONCLUSIONS
  The technique of mitral valve replacement with normothermic CPB without cross-clamping of the aorta may be safely used for the majority of patients requiring mitral valve replacement without causing deterioration in neurocognitive functions.
authors.affiliation: Department of Cardiovascular Surgery, Yuksek Ihtisas Hospital of Turkey, Ankara. drukervan@yahoo.com
authors.forename: Umit
authors.initials: U
authors.lastname: Kervan
authors.forename: Ferit
authors.initials: F
authors.lastname: Cicekcioglu
authors.forename: Hicran
authors.initials: H
authors.lastname: Tuluce
authors.forename: Anil
authors.initials: A
authors.lastname: Ozen
authors.forename: Seyhan
authors.initials: S
authors.lastname: Babaroglu
authors.forename: Sibel
authors.initials: S
authors.lastname: Karakas
authors.forename: Salih Fehmi
authors.initials: SF
authors.lastname: Katircioglu
mesh_terms: D000328:Adult; D001007:Anxiety / Q000209:etiology; D002315:Cardiopulmonary Bypass; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003072:Cognition Disorders / Q000209:etiology*; D003863:Depression / Q000209:etiology; D005260:Female; D006324:Heart Arrest, Induced; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D009483:Neuropsychological Tests; D011184:Postoperative Period; D011594:Psychometrics; D020127:Recovery of Function; D018709:Statistics, Nonparametric; D016896:Treatment Outcome