Method of prevention of neurovascular complications in cardiac surgery

Abstract

In Ukraine, cardiovascular diseases and their complications are among the leading causes of high mortality and population disability and cause 67.3% of deaths [1]. The main cause of cardiovascular mortality is CAD (coronary artery disease) and cerebrovascular disease. After cardiac surgery, the frequency of neurological dysfunctions develops more often than in general surgery. According to foreign researchers, the incidence of postoperative cognitive dysfunctions can reach up to 80% of patients in 1 week and 39% in 3 months after heart surgery [7]. Thus, the methods of anesthetic and brain protection at all stages of cardiac surgery in the conditions of artificial blood circulation are presented, which contributes to the efficiency and safety, as well as the development and implementation of new promising cardiosurgical technologies. It directly affects the cost of treatment for patients in a hospital, has a decisive influence on the capacity of the population and prevents the costs of financing such persons at the state level. Objective . Improve anesthetic provision of patients during operations with cardiopulmonary bypass to reduce the number of neurovascular complications in cardiac patients. Material and methods . The study material consisted of 220 patients with acquired heart defects and coronary heart disease, which was operated from 01.01.2014 to 31.12.2016 in the Scientific-Practical Medical Center of Pediatric Cardiology and Cardiac Surgery of the Ministry of Health of Ukraine. Cerebroprotective measures was used in patients during surgical intervention and in the early postoperative period. To ensure the homogeneity of patients in the study included patients with acquired heart defects, ≥ 65 years old, with the time of the arterial blood circulation ≥ 120 minutes. Results . To assess the effectiveness of the proposed advanced algorithm for anesthetic provision of patients with high risk of neurovascular complications, a number of criteria were selected, the analysis of which allows us to conclude that positive dynamics was observed in the study group as well as rapid improvement of neurological symptoms. Conclusions . The use of the proposed method of intraoperative protection of the brain statistically significantly reduces the number of neurovascular complications in the postoperative period by 13.5%.