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Eur J Cardiothorac Surg 2001;20:889
© 2001 Elsevier Science NL

Letter to the Editor

Neurocognitive impairment after minimally invasive aortic valve replacement

V. Zamvar, S. Webster, B. Falase

University Hospital of Wales, Cardiff, CF14 4XW, UK

Received 17 May 2001; accepted 5 July 2001.

Corresponding author. Tel.: +44-29-20747747; fax: +44-29-20745439
e-mail: zamvarv{at}hotmail.com

Key Words: Neurocognitive impairment • Aortic valve replacement

We read with great interest the paper by L.G. Svensson et al., on minimal access aortic surgery [1].

The authors state that the incidence of neurocognitive deficit was 1.8% (one out of 54 patients). This was done either by "extensive neurocognitive testing" or "by a patient complaint of loss of memory or mental acuity". They have not mentioned the battery of neurocognitive tests used or the manner in which they defined neurocognitive deficits. Loss of memory or mental acuity, as complained by the patient, is a very non-specific statement. Since only one patient in their series had neurocognitive deficit, was he tested with the "extensive battery of neurocognitive tests" or did he complain of "loss of memory or mental acuity"?

The reported incidence of neurocognitive deficits varies in the literature and the incidence is up to 79% [2].

The authors have reported excellent short-term results in their experience with minimal access aortic valve surgery. However, surely on the data they have presented, decreased neurocognitive impairment should not be counted among the benefits.

References

  1. Svensson L.G., Nadolny E.M., Kimmel W.A. Minimal access aortic surgery including re-operations. Eur J Cardio-thorac Surg 2001;19:30-33.[Abstract/Free Full Text]
  2. Shaw P.J., Bates D., Cartlidge N.E.F. An analysis of factors predisposing to neurological injury in patients undergoing coronary bypass operations. Q J Med 1989;72:633-646.[Abstract/Free Full Text]




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