Neurocognitive Outcome and Quality of Life after Thoracic Aortic Surgery with Deep Hypothermic Circulatory Arrest

• Published in: The Thoracic and Cardiovascular Surgeon
• Main Authors: Tutkun, B., Buz, S., Stamm, C., Hetzer, R.
• Format: Conference Proceeding
• Language: English
• Published: 20.01.2015
• ISSN: 0171-6425; 1439-1902
• DOI: 10.1055/s-0035-1544564

Objectives: Deep hypothermic circulatory arrest (DHCA) is a simple and effective method to protect the central nerve system. Despite the advantages of DHCA during aortic surgery, there are few studies about quality of life and changes in cognitive abilities after surgery. The aim of this study is to evaluate the impact of DHCA on long-term neurocognitive outcome. Methods: Between January 2000 and Januar 2014, 1569 patients underwent aortic surgery with use of DHCA (< 21°C) at our institution. The patients with acute type A aortic dissection (61%) were excluded from this study because of a possible influence on neurocognitive results. The patients under 60 years old without neurological sequelae were invited to participate and 50 patients (65% yield) were included in the study. Quality of life (QoL) was analyzed with the Short-Form 36 Health Survey Questionnaire (SF-36). For cognitive assessment we used four tests: the Mini-Mental Test, IQCODE, d2 Test and Trail Making. The tests were performed in our institution. Results: Mean duration of circulatory arrest was 26.3 ± 1 minute. The lowest nasopharingeal temperature (NPT) at the time of arrest was 16 ± 4°C. The QoL score did not differ significantly from the normal standards of the general population. The concentration (d2 test) scores were mostly better than the normal standard but there were also no significant differences in terms of DHCA time or NPT. The Mini-Mental and IQCODE, the tests used to evaluate the cognitive disorder or decline, showed no significant differences from the normal population's standards. Evaluation of the adequacy of neuropsychological functions (Trail Making) showed that DHCA patients had significantly much worse scores than the Standardization Data for Adults. Conclusions: The use of DHCA in aortic surgery does not cause any significant difference in cognitive function and does not affect the postoperative QoL.