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DOI: 10.1055/s-2007-967651
Influence of cardiopulmonary bypass management on neurocognitive function in biological aortic valve replacement – a prospective randomized trial
Aims: Biological aortic valve replacement causes irreversible neurocognitive deficits. We sought to determine if incidence and amount of neurocognitive deficit can be influence by temperature management during cardiopulmonary bypass.
Materials and methods: In this prospective randomized study, we measured the effects of mild hypothermic (32°C, n=30) vs. normothermic (37°C, n=30) CPB on neurocognitive function. All patients underwent elective isolated biological aortic valve replacement (mean age 67±8 years, mean ES 5.6±2.4). Neurocognitive function was objectively measured by objective P300 auditory-evoked potentials before surgery, 1 week and 4 months after surgery, respectively. Clinical data and outcome were monitored
Results: P300 evoked potentials were comparable between patients operated with mild hypothermic (370±30 ms) and normothermic CPB (373±32 ms) before the operation (p=0.847). P300 peak latencies were prolonged (=impaired) in patients operated with normothermic (402±29, p<.0001) and mild hypothermic CPB (405±30ms, p<.0001) 1 week after surgery. Impairment of P300 peak latencies was not reversible in patients operated with normothermic CPB (389±28ms, p=.003) and mild hypothermic CPB (400±33ms, p=.042) 4 months after surgery. Group comparison revealed no difference between patients operated with normothermic and mild hypothermic CPB 1 week (p=.542) and 4 months (p=.673) after surgery. Clinical data as well as postoperative adverse events were comparable between the two groups.
Conclusion: Biological aortic valve replacement causes long-term neurocognitive deficits. Temperature management during CPB does not influence the incidence and amount of neurocognitive deficit.