Zanatta Paolo, Messerotti Benvenuti S, Valfrè C, Baldanzi F, Palomba D
Anesthesia and Intensive Care Department, Treviso Regional Hospital, Italy.
Perfusion. 2012 May;27(3):199-206. doi: 10.1177/0267659112437776. Epub 2012 Feb 15.
Our objective was to determine the role of asymmetry and the nature of microembolization on postoperative cognitive decline in patients who had undergone heart valve surgery. Continuous transcranial Doppler ultrasound was intraoperatively used for both middle cerebral arteries in 13 right-handed heart valve surgery patients to detect microembolization. The Trail Making Test A and B, Memory with 10/30 s interference, the Digit Span Test and Phonemic Fluency were performed preoperatively, at discharge and three months after surgery. Our data suggest that early and late postoperative psychomotor and executive functions may be sensitive to microemboli in the left, but not in the right middle cerebral artery. Moreover, solid and gaseous microemboli are both similarly associated with early postoperative cognitive decline while, surprisingly, late postoperative cognitive decline is more likely to be associated with gaseous than solid microemboli.
我们的目标是确定不对称性的作用以及微栓塞的性质对接受心脏瓣膜手术患者术后认知功能下降的影响。术中对13名右利手心脏瓣膜手术患者的双侧大脑中动脉使用连续经颅多普勒超声来检测微栓塞。术前、出院时及术后三个月进行连线测验A和B、伴有10/30秒干扰的记忆测试、数字广度测试和语音流畅性测试。我们的数据表明，术后早期和晚期的精神运动及执行功能可能对左侧大脑中动脉的微栓子敏感，而对右侧大脑中动脉的微栓子不敏感。此外，固态和气态微栓子均与术后早期认知功能下降同样相关，而令人惊讶的是，术后晚期认知功能下降更可能与气态而非固态微栓子相关。
