Diagnosic features of postoperative cognitive dysfunction in patients after cardiosurgical interventions (literature review)

Алексеева, Т. М.; Portik, O. A.

doi:10.26442/2075-1753_2018.10.86-90

Cited by 4 publications

(3 citation statements)

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“…Несмотря на это, и по сегодняшний день сохраняются разногласия в унификации выбора оптимальной хирургической тактики у данной группы пациентов, а ряд исследователей указывает на необходимость совершенствования именно персонифицированного подхода к пациентам, поэтому особую роль играет полноценный сбор объективных данных, в том числе информация о состоянии морфологии и функции головного мозга [6,15]. Полученные нами данные о значимом снижении значений показателей перфузии головного мозга в отдельных зонах в послеоперационном периоде как в группе с АКШ, так и в группе с симультанными вмешательствами соотносятся с данными, встречающимися в литературе [1]…”

Section: Discussionunclassified

Changes in Cerebral Perfusion According to Single Photon Emission Computed Tomography after Coronary Artery Bypass Grafting and Simultaneous Interventions on the Carotid and Coronary Arteries

Короткевич

Семенов

Малева

et al. 2022

jour

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Goal of investigation was comparison and assessment of the state of cerebral perfusion according to SPECT data after coronary artery bypass grafting and simultaneous surgical intervention on the carotid and coronary arteries.Brain perfusion data were studied in 34 cardiac surgical patients who underwent surgical correction under conditions of cardiopulmonary bypass: simultaneous intervention on the coronary and carotid arteries (n = 21) and coronary artery bypass grafting (n = 13). The study of the brain was carried out by SPECT with the radiopharmaceutical 99mTc-HMPAO (Ceretek).In the group with CABG, there was a statistically significant decrease in the CBF values in the region of the caudate nucleus on the right, in both occipital and parietal lobes (p = 0.004193). In the group with simultaneous interventions, a significant decrease in the CBF indices in the right occipital and left parietal lobes (p = 0.020672), an increase in the indices in the left temporal lobe (p = 0.011286) was revealed.CBF indicators in the group with simultaneous interventions are significantly lower than those in the group with CABG both in the preoperative and postoperative periods.The data obtained indicate that patients with combined atherosclerotic lesions of the coronary and carotid arteries have significantly lower values of the CBF in comparison with patients with isolated changes in the coronary arteries.Coronary artery bypass grafting and simultaneous surgical interventions on the carotid and coronary arteries under cardiopulmonary bypass may be accompanied by a significant decrease in regional cerebral blood flow in certain areas of the brain, and these changes in the CABG group can be traced in a larger number of analyzed areas.

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Section: Discussionunclassified

Changes in Cerebral Perfusion According to Single Photon Emission Computed Tomography after Coronary Artery Bypass Grafting and Simultaneous Interventions on the Carotid and Coronary Arteries

Короткевич

Семенов

Малева

et al. 2022

jour

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“…В настоящее время не существует четких стандартов, регламентирующих диагностику КФ. Наиболее распро- ОРИГИНАЛЬНЫЕ СТАТЬИ § страненные методы -тест МоСа, шкала MMSE и проба Шульте, а также нейрофизиологическая диагностика, включающая электроэнцефалографию и нейровизуализацию (компьютерная томография и МРТ) [15]. Передовой технологией, позволяющей диагностировать морфологические и метаболические нарушения головного мозга, является функциональная МРТ, однако имеющая также свои ограничения в виде высокой стоимости исследования.…”

Section: Discussionunclassified

The state of cognitive function in patients with stable coronary artery disease after coronary artery bypass grafting

et al. 2021

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Aim To study the cognitive function (CF) state in patients with chronic ischemic heart disease (IHD) depending on the method of coronary bypass (CB), with extracorporeal circulation (EC) or on beating heart.Material and methods Postoperative cognitive dysfunction (POCD) is a frequent complication of CB, and its development may depend on the method of surgery, with EC or on beating heart. This single-center, prospective, nonrandomized study included 196 patients with chronic IHD aged 61.0±5.1 years. Patients were divided into two groups based on the CB method: an EC group (n=11) and a beating heart surgery group (n=85). Mean follow-up period was 26±2.1 mos. The state of CF was evaluated before and after CB (at the hospital stage, at 3, 6, 12, and 24 mos.).Results The mean duration of CF recovery was 3 mos. only in the group of CB without EC (p<0.05), whereas after CB with EC, CF parameters were similar to those during the hospital stage with somewhat reduced values. In 6 mos. after CB, CF normalized to baseline values in both groups (with and without EC). A possible CF decline in patients with chronic IHD after CB depended on the following factors: age older than 60 years (p<0.05), diabetes mellitus with glycated hemoglobin >7.5 % (p=0.001) and 6.5–7.5 % (p=0.03), smoking (p=0.04), atherosclerotic damage of the internal carotid artery (p<0.05), and a Charlson comorbidity index >5 (p=0.03). The CB surgery either with EC (p=0.04) or on beating heart (p=0.04) was associated with the development of CD.Conclusion The results of the study allow identifying patients with chronic IHD and POCD-predisposing factors to recommend them beathing heart CB surgery.

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“…В решении этой проблемы бесспорно большую роль играют различные методы нейровизуализации, в том числе методы ядерной диагностики, которые дают ценную информацию для клинических специалистов о состоянии структуры и функции головного мозга, что позволяет производить профилактику осложнений, своевременно выявлять и осуществлять терапию возникающей патологии. В современных публикациях отдельные авторы указывают на необходимость не только проведения дооперационного нейропсихологического тестирования с целью определения базового уровня когнитивных функций, но и сопоставления полученных результатов с данными нейрофизиологических и нейровизуализационных методов диагностики [1].…”

Section: однофотонная эмиссионная компьютерная томография в диагности...unclassified

Single-Photon Emission Computed Tomography in the Diagnosis of Cerebral Perfusion Changes in Cardiac and Vascular Surgery

Korotkevich¹,

Семенов²,

Trubnikova³

2023

Rejr

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The presented literature review is devoted to the issues of radionuclide diagnosis of brain perfusion during surgical interventions on the cardiovascular system. The main radiopharmaceuticals used for the SPECT technique are briefly reflected and the issues of data interpretation are raised, the possibilities of the technique are shown on the example of the experience of researchers in various surgical interventions. It has been established that brain scintigraphy is highly informative in detecting perfusion disorders, can help in the choice of surgical tactics and personalize the approach to the patient's treatment and thereby minimize harm to health. SPECT data expand the possibilities in studying the influence of perioperative factors on the state of the brain and cognitive functions. Literature search was performed using electronic databases Pub-Med, Google Shcolar, E-library.

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Diagnosic features of postoperative cognitive dysfunction in patients after cardiosurgical interventions (literature review)

Cited by 4 publications

References 0 publications

Changes in Cerebral Perfusion According to Single Photon Emission Computed Tomography after Coronary Artery Bypass Grafting and Simultaneous Interventions on the Carotid and Coronary Arteries

Changes in Cerebral Perfusion According to Single Photon Emission Computed Tomography after Coronary Artery Bypass Grafting and Simultaneous Interventions on the Carotid and Coronary Arteries

The state of cognitive function in patients with stable coronary artery disease after coronary artery bypass grafting

Single-Photon Emission Computed Tomography in the Diagnosis of Cerebral Perfusion Changes in Cardiac and Vascular Surgery

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