Comparison of Neurocognitive Functions after Beating-Heart Mitral Valve Replacement without Aorta Cross-Clamping and after Standard Mitral Valve Replacement with Cardioplegic Arrest

Abstract

<p><b>Background:</b> The aim of this study was to compare the postoperative long-term neurocognitive functions of patients who under-went beating-heart mitral valve replacement on cardiopulmonary bypass (CPB) without aorta cross-clamping with those of patients who underwent mitral valve replacement via the classic method.</p><p><b>Methods:</b> The study group included 25 randomly selected patients who underwent beating-heart mitral valve surgery. During the same period, 25 patients were randomly selected as controls to undergo mitral valve replacement procedures via the standard ascending aorta-cannulation technique. The clinical and postoperative (2 months) neurocognitive functional data of both groups were compared.</p><p><b>Results:</b> Neurologic deficit was observed in neither group during the postoperative period. There were no statistically significant differences between the control and the study groups with respect to Hospital Anxiety and Depression Scale (HADS) results (HADS: anxiety, <i>P</i> = .653; HADS: depression, <i>P</i> = .225), in the right hemispheric cognitive function test results (Raven's Standard Progressive Matrices [RSPM] and Line Orientation Test [LOT] tests: RSPM, <i>P</i> = .189), and in the left hemispheric cognitive function test results (the Ray Auditory Verbal Learning [RAVL] and Stroop Color-Word Test [SCWT] tests: SCWT 1 time, <i>P</i> = .300; SCWT 2 time, <i>P</i> = .679; SCWT 3 time, <i>P</i> = .336; SCWT 4 time, <i>P</i> = .852; SCWT 5 time, <i>P</i> = .416; RAVL total verbal learning, <i>P</i> = .167; RAVL immediate recall, <i>P</i> = .791; RAVL distraction trial, <i>P</i> = .199; RAVL retention, <i>P</i> = .174; RAVL delayed recall, <i>P</i> = .111; RAVL recognition, <i>P</i> = .282; SCWT 4 mistake, <i>P</i> = .306; SCWT 4 reform, <i>P</i> = .066; SCWT 5 mistake, <i>P</i> = .236; SCWT 5 reform, <i>P</i> = .301).</p><p><b>Conclusions:</b> The technique of mitral valve replacement with normothermic CPB without cross-clamping of the aorta may be safely used for the majority of patients requiring mitral valve replacement without causing deterioration in neurocognitive functions.</p>