Early neurological outcomes after simultaneous coronary artery bypass surgery and carotid endarterectomy

Малева, О. В.; Трубникова, О. А.; Сырова, И. Д.; Головин, А А; Барбараш, О. Л.; Барбараш, Л. С.

doi:10.17116/kardio201912051386

Cited by 2 publications

(1 citation statement)

References 10 publications

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“…Although this procedure is not always complicated by traumatic brain injury (stroke), it may cause a less pronounced, diffuse lesion that later leads to cognitive decline (Weimar et al, 2017;Maleva et al, 2020). Previous studies have shown that patients undergoing simultaneous coronary and carotid artery surgery present with a high incidence of postoperative cognitive dysfunction (POCD) in the early postoperative period (Maleva et al, 2019(Maleva et al, , 2020.…”

Section: Introductionmentioning

confidence: 99%

Cognitive functions and patterns of brain activity in patients after simultaneous coronary and carotid artery revascularization

Тарасова

Трубникова

Kupriyanova

et al. 2023

Front. Hum. Neurosci.

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BackgroundOn-pump coronary artery bypass grafting (CABG) is associated with a high risk of neurological complications in patients with severe carotid stenosis. Moreover, early postoperative cognitive dysfunction (POCD) incidence remains high in patients undergoing simultaneous coronary and carotid surgery. Recent studies have shown that even moderate carotid stenosis (≥50%) is associated with postoperative cognitive decline after CABG. Data on brain health in the postoperative period of simultaneous coronary and carotid surgery are limited.ObjectivesThis study aimed to analyze early postoperative changes in the cognitive function and patterns of brain electrical activity in patients after simultaneous coronary and carotid artery revascularization.Materials and methodsBetween January 2017 and December 2020, consecutive patients were assigned to on-pump CABG with or without carotid endarterectomy (CEA) according to clinical indications. An extended neuropsychological and electroencephalographic (EEG) assessment was performed before surgery and at 7–10 days after CABG or CABG + CEA.ResultsA total of 100 patients were included [median age 59 (55; 65), 95% men, MMSE 27 (26; 28)], and among these, 46 underwent CEA. POCD was diagnosed in 29 (63.0%) patients with CABG + CEA and in 32 (59.0%) patients with isolated CABG. All patients presented with a postoperative theta power increase. However, patients with CABG + right-sided CEA demonstrated the most pronounced theta power increase compared to patients with isolated CABG.ConclusionThe findings of our study show that patients with CABG + CEA and isolated CABG have comparable POCD incidence; however, patients with CABG + right-sided CEA presented with lower brain activity.

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Section: Introductionmentioning

confidence: 99%

Cognitive functions and patterns of brain activity in patients after simultaneous coronary and carotid artery revascularization

Тарасова

Трубникова

Kupriyanova

et al. 2023

Front. Hum. Neurosci.

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Secondary neurological outcomes in patients with brachiocephalic and coronary artery disease in the early postoperative period after simultaneous and hybrid surgical treatment

Малева

Трубникова

Тарасова

et al. 2021

Kompleks. probl. serdečno-sosud. zabol.

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Aim. To compare secondary neurological outcomes in patients with brachiocephalic and coronary artery disease in the early postoperative period after different surgical treatment strategies (simultaneous and hybrid).Methods. Secondary neurological outcomes were evaluated in 43 patients with coronary and brachiocephalic artery disease in the early postoperative period after (1) carotid endarterectomy and on-pump coronary artery bypass surgery; (2) percutaneous coronary intervention and carotid endarterectomy. Demographic, clinical, instrumental data were collected. Neuropsychological assessment was performed using the Mini-Mental State Examination and Frontal Assessment Battery. Memory, attention and neurodynamics were measured using the “Status-PF” software at days 2–3 before the surgery and at days 5–7 after it. The presence of postoperative cognitive dysfunction was estimated on the basis of criteria defined as a 20% decline on 20% of the tests. Statistical analysis was performed using the software package “Statistica 10.0”.Results. Patients who underwent hybrid intervention demonstrated improved attention and memory in the early postoperative period. Complex visual-motor reaction significantly increased in patients after simultaneous surgery. Attention differed significantly in both groups. Thus, patients from the hybrid group processed more characters per 1 and 4 minutes while completing the Bourdon proof reading test. The total number of processed characters prevailed in the hybrid group. Cognitive processing speed was higher in the hybrid group according to the brain performance test. The incidence of early postoperative cognitive dysfunction was 60% in patients after simultaneous surgery and 11% in patients after hybrid surgery (p = 0.006, OR±SE 12.5±3.2).Conclusion. Hybrid intervention has shown its superiority over simultaneous intervention in terms of low rate of early cognitive impairment, thereby confirming the necessity to take into account the obtained results while selecting the optimal surgical treatment in patients with coronary and brachiocephalic artery disease present with cognitive deficits at baseline.

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Early neurological outcomes after simultaneous coronary artery bypass surgery and carotid endarterectomy

Cited by 2 publications

References 10 publications

Cognitive functions and patterns of brain activity in patients after simultaneous coronary and carotid artery revascularization

Cognitive functions and patterns of brain activity in patients after simultaneous coronary and carotid artery revascularization

Secondary neurological outcomes in patients with brachiocephalic and coronary artery disease in the early postoperative period after simultaneous and hybrid surgical treatment

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