Hiraoka Kotaro, Kawatsu Satoshi, Mori Etsuro, Saiki Yoshikatsu
Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan.
Gen Thorac Cardiovasc Surg. 2012 Jun;60(6):345-9. doi: 10.1007/s11748-012-0057-8. Epub 2012 May 8.
It is controversial whether cerebral deficits other than frank stroke develop after total aortic arch replacement using hypothermic circulatory arrest (HCA) with antegrade selective cerebral perfusion (SCP).
We investigated neuropsychological functions in patients who received total aortic arch replacement using deep HCA with SCP.
Eleven patients who underwent elective total arch replacement using deep HCA with antegrade SCP were included. Cognitive functions of the patients were evaluated at baseline, and 3 weeks and 6 months after the aortic arch surgery.
The performance of cognitive tests did not change 3 weeks after surgery, except for the attention/calculation task of the Mini-Mental State Examination (MMSE). Six months after surgery, the decline in score for the attention/calculation task in the MMSE had reversed and the score for this task as well as for all other tests had returned to baseline levels.
Long-lasting cognitive deficits other than frank stroke may not develop after total arch replacement surgery using deep HCA with SCP.
在使用低温循环骤停（HCA）及顺行性选择性脑灌注（SCP）进行全主动脉弓置换术后，除明显卒中外是否会出现其他脑功能缺损仍存在争议。
我们调查了使用深度HCA及SCP进行全主动脉弓置换术患者的神经心理功能。
纳入11例行择期全主动脉弓置换术并使用深度HCA及顺行性SCP的患者。在基线、主动脉弓手术后3周和6个月时评估患者的认知功能。
术后3周，除简易精神状态检查表（MMSE）的注意力/计算任务外，认知测试表现未发生变化。术后6个月，MMSE中注意力/计算任务的得分下降情况已逆转，该任务及所有其他测试的得分均恢复至基线水平。
使用深度HCA及SCP进行全弓置换术后，除明显卒中外可能不会出现长期认知功能缺损。
