Internet-based assessment of postoperative neurocognitive function in cardiac and thoracic aortic surgery patients

Document Type

Journal Article

Publication Date

3-1-2011

Journal

Journal of Thoracic and Cardiovascular Surgery

Volume

141

Issue

3

DOI

10.1016/j.jtcvs.2010.08.024

Keywords

cardiopulmonary bypass; Cognitive Stability Index; CPB; CSI; HCA; hypothermic circulatory arrest; SCP; selective cerebral perfusion

Abstract

Objective: The primary purpose of this study was to determine the practicality of long-term, postoperative neurocognitive assessment via remote Internet-based testing in a cohort of patients who had undergone cardiac or thoracic aortic surgery within the previous 6 years. The secondary aim of this study was to examine the relationships among hypothermic circulatory arrest time, cardiopulmonary bypass time, and selective cerebral perfusion time with long-term postoperative neurocognitive function, as assessed by this novel testing method. Methods: Three hundred patients who had undergone cardiac and/or proximal aortic surgery with cardiopulmonary bypass (n = 207), thoracic aortic surgery with hypothermic circulatory arrest (n = 67), or thoracic aortic surgery with hypothermic circulatory arrest and selective cerebral perfusion (n = 26) within the previous 6 years underwent Internet-based neurocognitive assessment. Results: The duration of hypothermic circulatory arrest was negatively associated with processing speed scores and memory scores; arrest duration greater than 21 to 24 minutes was negatively associated with response speed scores. These associations were independent of time since surgery, age at testing, and educational level. Neither cardiopulmonary bypass duration nor selective cerebral perfusion duration was associated with test score results. Conclusions: This study demonstrated the practicality of long-term neurocognitive assessment of patients who have undergone cardiac and thoracic aortic surgery by means of Internet-based computerized testing. Furthermore, there was a negative association between the duration of intraoperative hypothermic circulatory arrest and long-term postoperative neurocognitive function that needs further examination in prospective studies. Copyright © 2011 by The American Association for Thoracic Surgery.

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