Characteristics of postoperative cerebral dysfunction depending on the type and position of the implanted prosthetic heart valve

Abstract

To study the prevalence and structure of postoperative cerebral dysfunction depending on the type and position of the implanted prosthetic heart valve in patients who underwent surgery for the acquired heart valve disease. The study included 115 patients (70 men and 45 women; 64 [56; 72] years old), who underwent elective replacement or repair surgery for the acquired heart valve disease. The postoperative cerebral dysfunction was diagnosed in 40.9% patients, including replacement in the aortic position (45.5%), in the mitral position (55%), in several positions (20%). Replacement surgery was accompanied by three clinical types of postoperative cerebral dysfunction and repair surgery - by deferred cognitive impairment only. Postoperative cerebral dysfunction after the replacement in the mitral position was more common (odds ratio 4.47, 95% confidence interval 1.21-18.35, p=0.041), including its acute clinical types - perioperative stroke and symptomatic delirium of the early postoperative period (p=0.029), compared to that after the repair heart valve surgery. After the replacement in the aortic position, acute clinical types of postoperative cerebral dysfunction were more common (p=0.036). After the replacement with biological prosthesis, symptomatic delirium of the early postoperative period was more common (p=0.047). The occurrence of the deferred cognitive impairment didn't depend on the type and position of the implanted prosthetic heart valve.