EVALUATION OF THE FREQUENCY OF DEVELOPMENT OF POSTOPERATIVE CEREBRAL DYSFUNCTION DEPENDING ON THE METHOD OF PROSTHETICS OF THE AORTAL VALVE OF THE HEART

The worldwide trend towards an increase in average life expectancy is associated with an increase in the prevalence of acquired heart defects, which at a certain stage dictates the need for cardiac surgery. We examined 72 patients (52 men and 20 women) who underwent planned aortic valve prosthetics. All patients were divided into two groups depending on the method of implantation of the prosthesis: the first group-aortic valve replacement when performing open surgery using cardiopulmonary bypass, the second group-endovascular prosthetics. The first group included 48 men and 18 women, whose average age was 66 years old; the second group included 4 men and 2 women, whose average age was 73 years. All patients underwent a comprehensive examination in the preoperative and postoperative periods, including an anamnesis assessment, a neurological examination using the NIHSS and Rankin scales, neuropsychological (Montreal Cognitive Assessment and frontal dysfunction battery) and psychometric (Hospital anxiety and depression scale) tests, as well as computed tomography the head in identifying clinical signs of perioperative stroke. Postoperative cerebral dysfunction was diagnosed in 44.4% (n = 32) of patients. The overall incidence of clinical types of postoperative cerebral dysfunction was as follows: perioperative stroke - 2.8% (n = 2), symptomatic delirium of the early postoperative period - 13.9% (n = 10), delayed cognitive impairment - 33.3% (n = 24) There were no acute clinical types of postoperative cerebral dysfunction in the endovascular treatment group. Delayed cognitive impairment in both groups were detected in 33.3% (in the first group n = 22, in the second group n = 2). According to the results of the study, acute clinical types of postoperative cerebral dysfunction were absent in the endovascular treatment group, cognitive impairment was detected in 1/3 of the patients in both groups.

postoperative cerebral dysfunction, perioperative stroke, symptomatic delirium of the early postoperative period, delayed cognitive impairment, neurology, cardiac surgery, prosthetics, heart valve, transcatheter aortic valve implantation