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http://hdl.handle.net/1942/33306
Title: | Neurological outcome after minimally invasive coronary artery bypass surgery (NOMICS): An observational prospective cohort study | Authors: | STESSEL, Bjorn NIJS, Kristof Pelckmans, Caroline VANDENBRANDE, Jeroen Ory, Jean-Paul Yilmaz, Alaaddin Starinieri, Pascal Van Tornout, Michiel DE KLIPPEL, Nina DENDALE, Paul |
Editors: | Testa, Luca | Issue Date: | 2020 | Publisher: | PUBLIC LIBRARY SCIENCE | Source: | PLoS One, 15 (12) (Art N° e0242519) | Abstract: | Background/Objectives Endoscopic coronary artery bypass grafting (Endo-CABG) is a minimally invasive CABG procedure with retrograde arterial perfusion. The main objective of this study is to assess neurocognitive outcome after Endo-CABG. Methods/Design In this prospective observational cohort study, patients were categorised into: Endo-CABG (n = 60), a comparative Percutaneous Coronary Intervention (PCI) group (n = 60) and a healthy volunteer group (n = 60). A clinical neurological examination was performed both pre- and postoperatively, delirium was assessed postoperatively. A battery of 6 neurocognitive tests, Quality of life (QoL) and the level of depressive feelings were measured at baseline and after 3 months. Patient Satisfaction after Endo-CABG was assessed at 3-month follow-up. Primary endpoints were incidence of postoperative cognitive dysfunction (POCD), stroke and delirium after Endo-CABG. Secondary endpoints were QOL, patient satisfaction and the incidence of depressive feelings after Endo-CABG. Results In total, 1 patient after Endo-CABG (1.72%) and 1 patient after PCI (1.67%) suffered from stroke during the 3-month follow-up. POCD in a patient is defined as a Reliable Change Index <=-1.645 or Z-score <=-1.645 in at least two tests, and was found in respectively 5 and 6 patients 3 months after Endo-CABG and PCI. Total incidence of POCD/stroke was not different (PCI: n= 7 [15.9%]; Endo-CABG: n= 6 [13.0%], p = 0.732). ICU delirium after Endo-CABG was found in 5 (8.6%) patients. QoL increased significantly three months after Endo-CABG and was comparable with QoL level after PCI and in the control group. Patient satisfaction after Endo-CABG and PCI was comparable. At follow-up, the level of depressive feelings was decreased in all groups. Conclusions The incidence of poor neurocognitive outcome, including stroke, POCD and postoperative ICU delirium until three months after Endo-CABG is low and comparable with PCI. | Notes: | Stessel, B (corresponding author), Jessa Hosp, Dept Anesthesiol & Pain Med, Hasselt, Belgium.; Stessel, B (corresponding author), Hasselt Univ, LCRC, Fac Med & Life Sci, Diepenbeek, Belgium. bjornstessel@hotmail.com |
Other: | Stessel, B (corresponding author), Jessa Hosp, Dept Anesthesiol & Pain Med, Hasselt, Belgium. Hasselt Univ, LCRC, Fac Med & Life Sci, Diepenbeek, Belgium. bjornstessel@hotmail.com | Document URI: | http://hdl.handle.net/1942/33306 | ISSN: | 1932-6203 | e-ISSN: | 1932-6203 | DOI: | 10.1371/journal.pone.0242519 | ISI #: | WOS:000603071600072 | Rights: | 2020 Stessel et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2022 |
Appears in Collections: | Research publications |
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journal.pone.0242519.pdf | Published version | 1.3 MB | Adobe PDF | View/Open |
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