Neurological and neurocognitive outcomes of routine deep hypothermic circulatory arrest with open distal anastomosis in ascending aortic and aortic root aneurysm surgery

Mehmet Inanc Yesilkaya, Anil Karaagac, Gulbun Asuman Yuksel, Tolga Can, Yusuf Kagan Pocan, Ozan Erturk, Burak Bozkurt, Mehmet Kaplan

Abstract

This study aimed to evaluate postoperative neurological and neurocognitive changes in patients undergoing ascending aortic and aortic root aneurysm surgery using the deep hypothermic circulatory arrest technique with open distal anastomosis performed without cerebral perfusion. Thirty-six patients (83.3% male, n = 30; 16.7% female, n = 6) were included. Demographic, operative, and postoperative data were recorded. Each patient underwent the Mini-Mental State Examination (MMSE), the Oktem Verbal Memory Processes Test (OVMPT), and the Wechsler Memory Scale-Visual Reproduction Test (WMS-VR) before and one week after surgery. Cerebral oxygen saturation levels were continuously monitored using near-infrared spectroscopy. Postoperative OVMPT scores showed significant improvement (p < 0.001). No significant change was observed in the WMS-VR, while MMSE scores showed a slight but significant postoperative decline (p < 0.001). No associations were found between neurocognitive outcomes and operative variables. These findings indicate that this procedure can be performed with acceptable early neurological outcomes.