Predictors of Cerebrovascular Disorders in Patients After Coronary Bypass Grafting

Sukhanov, S. G.; Марченко, А. В.; Мялюк, П А; Арутюнян, В Б; Чрагян, В А; Демакова, Е. В.; Vronsky, A. S.

doi:10.18786/2072-0505-2015-38-58-63

Alʹm. klin. med.

2016

DOI: 10.18786/2072-0505-2015-38-58-63

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Predictors of Cerebrovascular Disorders in Patients After Coronary Bypass Grafting

S. G. Sukhanov¹,

А. В. Марченко²,

П А Мялюк³

et al.

Abstract: Суханов Сергей Германович-д-р мед. наук, профессор, главный врач 1 Марченко Андрей Викторович-д-р мед. наук, заместитель главного врача 1

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Posthypoxic encephalopathy in patients undergoing coronary artery bypass surgery: clinical, neuropsychological, and neuroimaging aspects

Portik

Tsarevskaya

Efimtsev

et al. 2019

RJTAO

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Posthypoxic encephalopathy is a frequent complication after coronary artery bypass surgery (CABG), which includes stroke, early postoperative delirium, and postoperative cognitive dysfunction (PCD). The more pronounced prevalence and severity of the latter during surgery using extracorporeal circulation are currently being discussed.Objective: to analyze various types of cerebral dysfunction in patients undergoing CABG and to determine the role of perioperative factors in its development.Patients and methods. The investigation enrolled 53 patients who had undergone elective CABG for coronary heart disease. Group 1 included 20 patients who had undergone beating-heart surgery; Group 2 comprised 33 patients, in whom CABG had been performed using extracorporeal circulation (ECC). Neuropsychological testing and brain magnetic resonance imaging (MRI) (structural and functional techniques) were carried out.Results and discussion. Posthypoxic encephalopathy was diagnosed in 10 and 67% of patients in Group 1 and 2, respectively (p=0.05); these were precisely all the three types of brain dysfunction which were observed in Group 2 patients. Factors, such as over 70 years of age; median level of education; smoking; body mass index >30 kg/m2 ; ejection fraction <50%; class III effort angina; >210-min surgery duration; >55-min aortic ligation; and >115-min ECC, showed a statistically significant association with the onset of PCD (p<0.05). In Group 2, MRI revealed a weaker positive functional relationship of the medial prefrontal cortex with the posterior cingulate gyrus (<0.005); 18% of patients were found to have acute ischemic zones.Conclusion. Surgical myocardial revascularization using ECC is associated with a greater likelihood of PCD than beating-heart CABG. The factors that favored the development of PCD, such as increased age, low preoperative cognitive status, smoking, and long-term use of ECC, were identified when applying ECC.

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Posthypoxic encephalopathy in patients undergoing coronary artery bypass surgery: clinical, neuropsychological, and neuroimaging aspects

Portik

Tsarevskaya

Efimtsev

et al. 2019

RJTAO

View full text Add to dashboard Cite

show abstract

An analysis of postoperative cognitive dysfunction in different methods of coronary artery bypass

Alekseevich

Rodikov

Марченко

et al. 2017

Z. nevrol. psikhiatr. im. S.S. Korsakova

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Hospital and mid-term results of simultaneous correction of coronary and carotid arteries

Марченко

Vronsky

Myalyuk

et al. 2021

Evrazijskij kardiologičeskij žurnal

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Study objective: to present the immediate and mid-term results of onestage surgical treatment of patients in the volume of CEE and CABG based on a differentiated approach to patient selection.Materials and methods: in FCCVS n.a. S.G. Suhanov, Perm developed an algorithm for choosing treatment tactics in patients with combined atherosclerotic lesions of the coronary and brachiocephalic arteries. According to this algorithm, for the period from 01.07.2014-01.01.2021, one-stage correction of CABG + CEE was performed in 104 patients. The primary endpoints were all-cause death, acute myocardial infarction (MI), transient ischemic attack (TIA), and stroke. Hospital and midterm results were analyzed. The average follow-up time in the study of mid-long-term results was 40.3 ± 20.4 months.Results: in the study of hospital outcomes, the mortality rate was 0%. There were recorded 3 (2.9%) cases of perioperative stroke and 1 (0.9%) case of myocardial infarction. There were no cases of TIA. The combined endpoint (death, acute MI, stroke, TIA) reached 4 (3.8%) patients. In the study of mid-term results, we were able to contact 96 patients out of 104 operated on (92.3%). The survival rate was 94.8%. 5 (5.2%) people died. There were 2 (2.1%) cases of myocardial infarction, 4 (4.1%) cases of stroke.Conclusions: simultaneous revascularization of the carotid and coronary regions of CABG + CEE is safe and allows adequate elimination of the lesion in both regions.

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Predictors of Cerebrovascular Disorders in Patients After Coronary Bypass Grafting

Abstract: Суханов Сергей Германович-д-р мед. наук, профессор, главный врач 1 Марченко Андрей Викторович-д-р мед. наук, заместитель главного врача 1

Cited by 3 publications

References 0 publications

Posthypoxic encephalopathy in patients undergoing coronary artery bypass surgery: clinical, neuropsychological, and neuroimaging aspects

Posthypoxic encephalopathy in patients undergoing coronary artery bypass surgery: clinical, neuropsychological, and neuroimaging aspects

An analysis of postoperative cognitive dysfunction in different methods of coronary artery bypass

Hospital and mid-term results of simultaneous correction of coronary and carotid arteries

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