Effect Of Beating Heart Intracardiac Procedures With Cardiopulmonary Bypass On Early Postoperative Cognitive Dysfunction And Serum S100B

ObjectiveTo investigate the effect of beating heart intracardiac procedures with cardiopulmonary bypass on early postoperative cognitive dysfunction and serum S100B.MethodsSixty patients aged 15~45ys undergoing intracardiac procedures with cardiac arrest or beating heart during cardiopulmonary bypass were included in this study and divided into two group: group A (Arrested heart group) and group B (Beating heart group). The decision to perform the surgery with cardiac arrest or beating heart was based on surgery factors alone, and was not influenced by inclusion in the study. Forty unpaid volunteers were recruited to provide the data required to calculate the modified reliable change indices (MRCI). The volunteers were matched with the surgical groups in age, gender, years of education. The surgical patients were administered a battery of neuropsychologic tests by the same examiner preoperatively and on 7th day after cardiac surgery. All control subjects were administered an identical battery of neuropsychologic tests by the same examiners over an identical interval. Patient who had a deficit on more than 2 measures was defined as cognitive dysfunction. Blood samples were collected before operation , and 24 h after cardiac surgery for measuring levels of serum protein S100B by ELISA. ResultsArrested heart group (group A) consisted of 14 isolated valve surgery patients and 14 reconstructive cardiac surgery patients. Beating heart group (group B) consisted of 23 patients undergoing reconstructive cardiac surgery. There were no significant differences in ages, weight, ratio of gender and education years between group A, group B and volunteers. Practice effect occurred in Cumulate Test, Visual Retention, Paired Associate Verbal Learning, Digit Symbol and Trail Making Test (Part A).The incidence of POCD in group A is 42.9%,while 34.8% in group B(P >0.05). The concentration of serum S100B at 24 hours after cardiac surgery was 0.37±0.17μg/L in group B and 0.35±0.18μg/L in group A. There were no statistical differences between both groups.ConclusionsBeating heart intracardiac procedures with cardiopulmonary bypass does not decrease the incidence of early cognitive deficits after cardiac surgery, and does not reduce the release of S100B.