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SHR Neuro Cancer Cardio Lipid Metab Microb

Zimpfer, D; Czerny, M; Schuch, P; Fakin, R; Madl, C; Wolner, E; Grimm, M.
Long-term neurocognitive function after mechanical aortic valve replacement.
Ann Thorac Surg. 2006; 81(1):29-33 Doi: 10.1016/j.athoracsur.2005.06.039
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Leading authors Med Uni Graz: Zimpfer Daniel
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Abstract:: BACKGROUND: Mechanical aortic valves are a possible source of microemboli potentially causing cerebral injury. Therefore, the long-term impact of mechanical aortic valve replacement on neurocognitive function is uncertain. METHODS: In this prospective, contemporary study, we followed 32 consecutive patients (aged 51 +/- 8 years; range, 38 to 70; EuroSCORE [European System for Cardiac Operative Risk Evaluation] 4.4 +/- 1.7) undergoing isolated aortic valve replacement with a mechanical prosthesis. A cohort of age- and sex-matched patients (n = 28, aged 50 +/- 7 years) served as nonsurgical controls. After aortic valve replacement, neurocognitive function was serially reevaluated at 7-day (n = 32), 4-month (n = 31), and 3-year (n = 29) follow-up. Neurocognitive function was measured by means of P300 auditory evoked potentials. RESULTS: Before the operation, P300 peak latencies were comparable between surgical patients (361 +/- 32 ms) and nonsurgical controls (365 +/- 33 ms, p = 0.783). In patients undergoing aortic valve replacement, P300 peak latencies were prolonged 7 days after surgery (380 +/- 32 ms) as compared with before the operation (361 +/- 32 ms, p < 0.0001) and as compared with nonsurgical controls (364 +/- 34 ms, p = 0.002). At 4-month (369 +/- 30 ms, p = 0.752) and 3-year (370 +/- 31 ms, p = 0.825) follow-up, P300 peak latencies normalized as compared with before operation and as compared with nonsurgical controls (4-month follow-up 363 +/- 31 ms, p = 0.832; 3-year follow-up 366 +/- 32 ms, p = 0.432). We found no difference in patients with different valve types. CONCLUSIONS: Despite previous assumptions based on the potential occurrence of microemboli in patients with mechanical valves, mechanical aortic valve replacement has no adverse long-term impact on neurocognitive function. This finding is only valid for patients with a comparable age range undergoing isolated aortic valve replacement.
Find related publications in this database (using NLM MeSH Indexing): Adult - administration & dosage; Aged - administration & dosage; Anticoagulants - therapeutic use; Aortic Valve - surgery; Atrial Fibrillation - complications, epidemiology; Cognition Disorders - diagnosis, epidemiology, etiology, psychology; Cohort Studies - administration & dosage; Event-Related Potentials, P300 - administration & dosage; Female - administration & dosage; Follow-Up Studies - administration & dosage; Heart Valve Prosthesis - adverse effects; Heart Valve Prosthesis Implantation - administration & dosage; Humans - administration & dosage; Intracranial Embolism - epidemiology, etiology, psychology; Male - administration & dosage; Middle Aged - administration & dosage; Postoperative Complications - diagnosis, epidemiology, etiology, psychology; Prospective Studies - administration & dosage; Reaction Time - administration & dosage; Treatment Outcome - administration & dosage