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Eur J Cardiothorac Surg 2005;28:102-103
© 2005 Elsevier Science NL

Editorial comment

University Hospital Birmingham NHS Trust, Birmingham, UK

^* Corresponding author. Address: Cardiothoracic Surgery Unit, Queen Elizabeth Medical Centre, University Hospital, Edgbaston, B15 3RB Birmingham, UK. Tel.: +44 1214 721311; fax: +44 1216 272542. (Email: r.s.bonser@bham.ac.uk).

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In an era in which mortality risk for complex cardiac surgery is reducing, there is an increased focus on reducing morbidity. Brain injury following cardiac surgery remains important and represents a spectrum through grave irrecoverable global injury, focal irreversible and reversible neurological deficit, transient post-operative neurological dysfunction and more subtle neurocognitive change [1,2]. In this issue, Miyairi et al. [3], report neurocognitive outcomes in two series of patients, 28 undergoing coronary artery bypass surgery (CABG) and 46 undergoing aortic arch surgery utilizing retrograde cerebral perfusion (RCP), of which 19 underwent RCP for durations >60min. This study is the first of its kind to compare neurocognitive outcome between RCP and a standard CABG group, i.e. a group undergoing cardiopulmonary bypass but not requiring a period of hypothermic circulatory arrest. From our own experience [4,5] thoracic aortic patients are a difficult group to study neurocognitively and this cohort of 46 aortic patients is the largest group of RCP patients to be studied so far. The authors are, therefore, to be congratulated on the performance of a difficult clinical task. Moreover, . . . [Full Text of this Article]