title: Total aortic arch replacement using hypothermic circulatory arrest with antegrade selective cerebral perfusion: are there cerebral deficits other than frank stroke?
abstract: BACKGROUND
  It is controversial whether cerebral deficits other than frank stroke develop after total aortic arch replacement using hypothermic circulatory arrest (HCA) with antegrade selective cerebral perfusion (SCP).
  
  
  OBJECTIVE
  We investigated neuropsychological functions in patients who received total aortic arch replacement using deep HCA with SCP.
  
  
  METHODS
  Eleven patients who underwent elective total arch replacement using deep HCA with antegrade SCP were included. Cognitive functions of the patients were evaluated at baseline, and 3 weeks and 6 months after the aortic arch surgery.
  
  
  RESULTS
  The performance of cognitive tests did not change 3 weeks after surgery, except for the attention/calculation task of the Mini-Mental State Examination (MMSE). Six months after surgery, the decline in score for the attention/calculation task in the MMSE had reversed and the score for this task as well as for all other tests had returned to baseline levels.
  
  
  CONCLUSIONS
  Long-lasting cognitive deficits other than frank stroke may not develop after total arch replacement surgery using deep HCA with SCP.
authors.affiliation: Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan. khiraoka@cyric.tohoku.ac.jp
authors.forename: Kotaro
authors.initials: K
authors.lastname: Hiraoka
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kawatsu
authors.forename: Etsuro
authors.initials: E
authors.lastname: Mori
authors.forename: Yoshikatsu
authors.initials: Y
authors.lastname: Saiki
mesh_terms: D000368:Aged; D001013:Aorta, Thoracic / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D002560:Cerebrovascular Circulation; D050792:Circulatory Arrest, Deep Hypothermia Induced / Q000009:adverse effects*; D003071:Cognition; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010477:Perfusion / Q000009:adverse effects*; D020521:Stroke / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology; D013997:Time Factors; D016896:Treatment Outcome