THE STRUCTURE OF POSTOPERATIVE CEREBRAL DYSFUNCTION AND BRAIN PROTECTION IN THE SURGICAL TREATMENT OF AORTIC VALVE DISEASE
AIM: to establish the structure of postoperative cerebral dysfunction in patients after aortic valve bypass surgery and to evaluate the effectiveness of the postoperative use of meglumine sodium succinate to protect the brain and prevent clinical types of postoperative cerebral dysfunction. MATERIALS AND METHODS: We examined 98 patients (80 men and 18 women) aged 63 years [56; 72], who underwent elective aortic valve surgery with complete and parallel cardiopulmonary bypass, normothermia, and general combined multicomponent anesthesia with mechanical ventilation. Depending on the type of postoperative cerebroprotection, the patients were divided into two groups - “Basic therapy” ( n = 82) and “Cerebroprotection” ( n = 16). All patients in the perioperative period received standard drug therapy for acquired heart valve pathology, symptomatic treatment. Patients in the “Cerebroprotection” group additionally received the 1.5 % solution of meglumine sodium succinate in the postoperative period. RESULTS: The incidence of postoperative cerebral dysfunction, as well as its clinical types, did not differ in the study groups ( p > 0.05). The most commonly diagnosed clinical type of postoperative brain dysfunction was deferred cognitive impairment. Postoperative stroke was diagnosed in 2 patients (2.4 %) in the “Basic therapy” group only. The duration of symptomatic delirium in the early postoperative period in the “Cerebroprotection” group was less than in the “Basic therapy” group (4 [3; 5] days versus 1.5 [1.25; 1.75] days, p < 0.001). CONCLUSION: Aortic valve surgery is characterized by the high incidence of postoperative cerebral dysfunction - in almost half of patients. The results of the study suggest the effectiveness of postoperative use of meglumine sodium succinate to protect the brain during aortic valve replacement surgery with cardiopulmonary bypass (1 figure, 3 tables, bibliography: 24 refs).