Prediction of cognitive dysfunction and patients' outcome following valvular heart surgery and the role of cerebral oximetry

Seong Wook Hong, Jae Kwang Shim, Yong Seon Choi, Dae Hee Kim, Byung Chul Chang, Young Lan Kwak

Research output: Contribution to journalArticle

73 Citations (Scopus)

Abstract

Objective: Postoperative cognitive dysfunction (POCD) commonly develops after cardiac surgery affecting patients' outcome. Cerebral oximetry noninvasively measures regional cerebral oxygen saturation (rSO2) and significant correlation has been reported between intraoperative cerebral desaturation and POCD, as well as patients' outcome following coronary artery bypass grafting. However, evidence is limited in valvular heart surgery (VHS). We investigated the relationship of intraoperative rSO2 values with POCD and length of postoperative hospitalization in patients undergoing VHS. Methods: One hundred patients undergoing elective VHS were enrolled. Neurocognitive evaluation was performed with Mini-Mental State Examination, Trail-Making Test (Part A), and Grooved Pegboard Test at 1 day before and 7th day after surgery. During surgery, rSO2 was continuously monitored and the incidence and duration of decrease in rSO2 values for five consecutive minutes were recorded as follows; (1) decrease in absolute rSO2 values to less than 50%, (2) 40%, and (3) a 20% decrease compared to baseline value. Results: Twenty-three patients (23%) demonstrated POCD. We could not observe any significant differences in either the incidence or duration of decrease in rSO2 values between patients with and without POCD. Low education level and higher baseline temperature had significant correlation with POCD. Patients with cerebral desaturation required significantly longer postoperative hospitalization. Conclusion: In patients undergoing VHS, POCD could not be predicted with cerebral oximetry. However, patients with intraoperative cerebral desaturation required significantly longer postoperative hospitalization and cerebral oximetry appears to be promising in terms of monitoring the brain as the index organ for systemic perfusion and improving patients' outcome.

Original languageEnglish
Pages (from-to)560-565
Number of pages6
JournalEuropean Journal of Cardio-thoracic Surgery
Volume33
Issue number4
DOIs
Publication statusPublished - 2008 Apr

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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