Single aortic clamping in coronary artery bypass surgery reduces cerebral embolism and improves neurocognitive outcomes

Vascular Medicine (United Kingdom)

Volumn 18, Issue 5, 2013, Pages 275-281

  Gasparovic, Hrvoje ^a   Borojevic, Marko ^a   Malojcic, Branko ^a   Gasparovic, Kristina ^a   Biocina, Bojan ^a  

^a KBC Zagreb   (Croatia)

Author keywords

cerebral embolism; coronary artery bypass grafting; neurocognitive outcome; transcranial Doppler ultrasound

Indexed keywords

ACETYLSALICYLIC ACID; BETA ADRENERGIC RECEPTOR BLOCKING AGENT; HYDROXYMETHYLGLUTARYL COENZYME A REDUCTASE INHIBITOR;

ADULT; AGED; AMNESIA; ANTICOAGULATION; ANTIPHOSPHOLIPID SYNDROME; AORTA CLAMPING; ARTICLE; ARTIFICIAL EMBOLISM; BRAIN EMBOLISM; COGNITION; CONTROLLED STUDY; CORONARY ARTERY BYPASS GRAFT; DEPRESSION; DOPPLER ECHOGRAPHY; FOLLOW UP; HUMAN; HYPERLIPIDEMIA; INTERMETHOD COMPARISON; INTRAOPERATIVE PERIOD; LEARNING TEST; LUNG EMBOLISM; MAJOR CLINICAL STUDY; MALE; MEMORY CONSOLIDATION; MINI MENTAL STATE EXAMINATION; MOTOR PERFORMANCE; NEUROIMAGING; OUTCOME ASSESSMENT; PEROPERATIVE CARE; POSTOPERATIVE CARE; POSTOPERATIVE COGNITIVE DYSFUNCTION; POSTOPERATIVE DELIRIUM; PRIORITY JOURNAL; PROSPECTIVE STUDY; TRANSCRANIAL DOPPLER;

CEREBRAL EMBOLISM; CORONARY ARTERY BYPASS GRAFTING; NEUROCOGNITIVE OUTCOME; TRANSCRANIAL DOPPLER ULTRASOUND;

AGED; AORTA; CARDIOPULMONARY BYPASS; COGNITION DISORDERS; CONSTRICTION; CORONARY ARTERY BYPASS; FEMALE; HUMANS; INTRACRANIAL EMBOLISM; MALE; MIDDLE AGED; NEUROPSYCHOLOGICAL TESTS; POSTOPERATIVE COMPLICATIONS; PROSPECTIVE STUDIES; TREATMENT OUTCOME; ULTRASONOGRAPHY, DOPPLER, TRANSCRANIAL;

EID: 84887007179     PISSN: 1358863X     EISSN: 14770377     Source Type: Journal    
DOI: 10.1177/1358863X13502699     Document Type: Article

References (23)

1. Liu YH, Wang DX, Li LH, et al. The effects of cardiopulmonary bypass on the number of cerebral microemboli and the incidence of cognitive dysfunction after coronary artery bypass graft surgery. Anesth Analg. 2009 ; 109: 1013-1022
2. Grocott HP, Yoshitani K. Neuroprotection during cardiac surgery. J Anesth. 2007 ; 21: 367-377
3. Ghogawala Z, Westerveld M, Amin-Hanjani S. Cognitive outcomes after carotid revascularization: the role of cerebral emboli and hypoperfusion. Neurosurgery. 2008 ; 62: 385-395
4. Abu-Omar Y, Cader S, Guerrieri Wolf L, Pigott D, Matthews PM, Taggart DP. Short-term changes in cerebral activity in on-pump and off-pump cardiac surgery defined by functional magnetic resonance imaging and their relationship to microembolization. J Thorac Cardiovasc Surg. 2006 ; 132: 1119-1125
5. Hoffman GM. Neurologic monitoring on cardiopulmonary bypass: what are we obligated to do?. Ann Thorac Surg. 2006 ; 81: S2373-2380
6. Russell D. Cerebral microemboli and cognitive impairment. J Neurol Sci. 2002 ; 203-204: 211-214
7. Rodriguez RA, Rubens FD, Wozny D, Nathan HJ. Cerebral emboli detected by transcranial Doppler during cardiopulmonary bypass are not correlated with postoperative cognitive deficits. Stroke. 2010 ; 41: 2229-2235
8. Dittrich R, Ringelstein EB. Occurrence and clinical impact of microembolic signals during or after cardiosurgical procedures. Stroke. 2008 ; 39: 503-511
9. Martin KK, Wigginton JB, Babikian VL, Pochay VE, Crittenden MD, Rudolph JL. Intraoperative cerebral high-intensity transient signals and postoperative cognitive function: a systematic review. Am J Surg. 2009 ; 197: 55-63
10. Lynch JE, Riley JB. Microemboli detection on extracorporeal bypass circuits. Perfusion. 2008 ; 23: 23-32
11. Rodriguez RA, Rubens F, Rodriguez CA, Nathan HJ. Sources of variability in detection of cerebral emboli with transcranial Doppler during cardiac surgery. J Neuroimaging. 2006 ; 16: 126-132
12. Markus HS, Molloy J. Use of a decibel threshold in detecting Doppler embolic signals. Stroke. 1997 ; 28: 692-695
13. Rudolph JL, Schreiber KA, Culley DJ, et al. Measurement of post-operative cognitive dysfunction after cardiac surgery: a systematic review. Acta Anaesthesiol Scand. 2010 ; 54: 663-677
14. Rosenbloom JI, Wellenius GA, Mukamal KJ, Mittleman MA. Self-reported anxiety and the risk of clinical events and atherosclerotic progression among patients with Coronary Artery Bypass Grafts (CABG). Am Heart J. 2009 ; 158: 867-873
15. Messinis L, Tsakona I, Malefaki S, Papathanasopoulos P. Normative data and discriminant validity of Rey's Verbal Learning Test for the Greek adult population. Arch Clin Neuropsychol. 2007 ; 22: 739-752
16. Van der Elst W, van Boxtel MP, van Breukelen GJ, Jolles J. Rey's verbal learning test: normative data for 1855 healthy participants aged 24-81 years and the influence of age, sex, education, and mode of presentation. J Int Neuropsychol Soc. 2005 ; 11: 290-302
17. Ruff RM, Parker SB. Gender- and age-specific changes in motor speed and eye-hand coordination in adults: normative values for the Finger Tapping and Grooved Pegboard Tests. Percept Mot Skills. 1993 ; 76: 1219-1230
18. The Society of Thoracic Surgeons Database. Available at: http://www.sts.org/sites/default/files/documents/ GTDB%20TRAINING%20MANUALIntent%20Clarification-2081-Final%20021709-0.pdf. (accessed 12 March 2010).
19. Fearn SJ, Pole R, Wesnes K, Faragher EB, Hooper TL, McCollum CN. Cerebral injury during cardiopulmonary bypass: emboli impair memory. J Thorac Cardiovasc Surg. 2001 ; 121: 1150-1160
20. Rodriguez RA, Williams KA, Babaev A, Rubens F, Nathan HJ. Effect of perfusionist technique on cerebral embolization during cardiopulmonary bypass. Perfusion. 2005 ; 20: 3-10
21. Grega MA, Borowicz LM, Baumgartner WA. Impact of single clamp versus double clamp technique on neurologic outcome. Ann Thorac Surg. 2003 ; 75: 1387-1391
22. Hammon JW, Stump DA, Butterworth JF, et al. Coronary artery bypass grafting with single cross-clamp results in fewer persistent neuropsychological deficits than multiple clamp or off-pump coronary artery bypass grafting. Ann Thorac Surg. 2007 ; 84: 1174-1178
23. Van Dijk D, Spoor M, Hijman R, et al. Cognitive and cardiac outcomes 5 years after off-pump vs on-pump coronary artery bypass graft surgery. JAMA. 2007 ; 297: 701-708