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Title: A clinical study of the neuropsychological outcome comparing cardioplegic arrest versus intermittent cross-clamp fibrillation as myocardial protection techniques in coronary artery bypass grafting surgery
Author: Suvarna, S. H.
Awarding Body: University College London (University of London)
Current Institution: University College London (University of London)
Date of Award: 2013
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Objective: A randomized clinical trial seeking evidence as to whether cardioplegic arrest (CA) or intermittent cross-clamp fibrillation (ICCF) method of myocardial protection technique would have any effect on the post-operative neuropsychological outcome in patients undergoing elective coronary artery bypass grafting (CABG) surgery. Methods: One hundred and ninety-five patients were randomized to either CA or ICCF as the method of myocardial protection technique. Cerebral microemboli (ME) during surgery were recorded by transcranial Doppler monitor over the right middle cerebral artery. Evidence of cerebral impairment was obtained by comparing the patients’ performance in a neuropsychological test battery (9 tests) administered 6-8 weeks post-operatively with their pre-operative scores. Results: The groups proved well balanced in pre-operative variables. During cardiopulmonary bypass (CPB) the median number and range of microemboli was 110 (1-1306) in the CA group compared to 105 (9-1757) for the ICCF group (p<0.567). One hundred and seventy-seven patients completed all the neuropsychological tests. The difference between the two groups did not reach significance (p=0.326, 2 tailed t test). Conclusion: Given the similarity of effect in CA and ICCF techniques on the generation of ME and neuropsychological outcomes during CABG surgery, this investigation suggests that other than the myocardial protection technique analysed, there are other multiple causes that need to be studied.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available