Ankstyvas kognityvinių funkcijų pakenkimas po vainikinių arterijų apeinamųjų jungčių suformavimo operacijų, rizikos veiksniai ir asimptominės miego arterijos stenozės įtaka

Introduction. Nowadays, succesfull treatment in cardiac surgery is determined not only by the absence of complications, but rather by the guality of post operative life of the patient. Returntonor malactivity post operativelly is of tendisturbed by the worsening of neuro psychological status of the patient. Cognitive declineis one of the most controversal complications following cardiac surgery, widely discussed in modern medical literature. The aim of our study was to determine preoperative risk factors associated with neuro cognitive complications and investigate whether asymptomaticcarotidarterystenos is has an impact on post operative cognition. Methods. We collected data of 127 consecutive patients, under going on pump CABG at our institution. Neuropsychological testing was conducted preoperatively and 7-10 days after surgery. Ultra sound examination of carotidarteries was performed forevery patient as a part of preoperative examination. Results. Early post operative cognitive decline (POCD) was detected in 46%of patients. Patients in POCD group were older (p=0.03), had higher preoperative risks core(p=0.009).Cognitive decline was associated with such factors as longer operation time(p=0.02), low cardiac output syndromeperioperativelly (p<0.05), postoperative bleeding (p=0.03) andeventuallylongermechanical ventilation and intensive care unit stay (p<0.05). Carotidartery lesion was detected in 42 (68.8% patients. Multi variate regression analysis showed that carotidartery stenosis of more than 50% was an independent predict or of POCD (OR26.89,CI6.44-112.34). Conclusions. Postoperativecognitive decline is afrequent complication following coronary artery by pass grafting. The incidence of POCD was associated with perioperative hemo dynamic in stability, post operative bleeding, delirium or cardiac arrhythmias. Increasedage, carotidarterystenosis, longer operation and mechanical ventilationtime, were independent predictors of post operative cognitive impairment. [ABSTRACT FROM AUTHOR]