MONITORING OF COGNITIVE DYSFUNCTIONS AFTER CORONARY ARTERY BYPASS

Abstract

Introduction. The problem of the development of cognitive dysfunctions, both immediate complications of anesthesiologic support of cardiac surgical interventions, and long-term cognitive changes in the distant term, is gaining importance with the increase in the frequency and expansion of the volume of operations in cardiac surgery practice. The purpose of the work is to investigate the state of cognitive function in the early and delayed postoperative period in patients with coronary heart disease who underwent coronary bypass surgery. Materials and methods. A retrospective analysis of the disease histories of 213 patients with coronary artery disease, who underwent coronary bypass grafting without the use of artificial blood circulation on the Shalimov National Institute of surgery and transplantology of the National Academy of Sciences of Ukraine during 2019-2021. Results and discussion. In preoperative MMSE testing, patients scored 27.51±2.54 points, on the 3rd day after the operation – a significant decrease in the indicator to 23.32±1.43 points, on the 6-8th day after the operation, the patients scored 24.98±1.71, after 6 months – 25.27±2.31 points (р≤0.05). The results of the Trial Making Test (part A) showed that at the initial level, on average, 29.41±1.55 s, cognitive functions weakened: on the 3rd day – 34.63±2.26 s, on the 6-8th day – 32 ,71±3.32 s. 6 months after the operation, the test results were 31.31±2.33 s. The second part of the Trial Making Test (part B) showed the results: before the operation – 69.22±3.41 s, on the 3rd day – 74.27±2.76 s, on the 6-8th day – 73.42±2 .65 s, after 6 months – 70.23±2.97 s. 6 months after the operation, only 15 patients (15.31%) out of 98 people with POCD had cognitive functions restored to the level of the preoperative period. Conclusions. POCDs were detected in 46.0% of patients with coronary heart disease who underwent coronary bypass surgery, while 84.7% of them remain in the distant term up to 6 months after discharge.