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[Left ventricular decompression and neuropsychiatric disorders in coronary surgery]
Annales De Chirurgie
|January 1, 1993
Summary
The use of a left ventricular vent during coronary artery bypass surgery is linked to increased neuropsychiatric morbidity. Removing the vent significantly reduces these adverse events, suggesting gaseous microemboli are the cause.
Area of Science:
- Cardiovascular Surgery
- Neurology
- Medical Devices
Context:
- Coronary artery bypass (CAB) surgery is a common procedure.
- Neuropsychiatric morbidity (NPM) is a potential complication following CAB.
- Previous studies have not definitively identified the cause of NPM post-CAB.
Purpose:
- To investigate the cause of decreased neuropsychiatric morbidity (NPM) following coronary artery bypass (CAB) surgery.
- To identify specific surgical factors contributing to NPM.
- To evaluate the impact of left ventricular vent (LVV) use and oxygenator type on NPM.
Summary:
- A retrospective study of 258 CAB procedures compared outcomes with and without a left ventricular vent (LVV).
- Patients undergoing CAB with an LVV (Group A) had a significantly higher incidence of NPM (24.6%) compared to those without (Group B, 12.3%).
- The type of oxygenator (bubble vs. membrane) or the use of an arterial line filter did not significantly alter NPM rates.
Impact:
- The findings suggest that the introduction of air into the left ventricle via an LVV catheter is a primary cause of gaseous microembolic events.
- These microembolic events are responsible for neuropsychiatric morbidity following CAB.
- Eliminating the LVV during CAB surgery can reduce the incidence of postoperative neuropsychiatric complications.