Noninvasive Neuromonitoring of Surgery of the Thoracic Aorta

University of Helsinki

Status: Completed

Conditions: Coronary Artery Disease; Cardiopulmonary Arrest; Aortic Aneurysm, Thoracic; Aortic Diseases

Study type: Observational

Funder types: Other; Industry

Identifiers

NCT02876263

HUS 133/E6/07

Details and patient eligibility

About

The aim of this prospective, explorative study of noninvasive neuromonitoring was to search potential and practical methods associated with neurological outcome in the perioperative and immediate postoperative setting of surgery of the thoracic aorta. These methods include abbreviated EEG monitoring, near-infrared spectroscopy, transcranial Doppler ultrasound and biochemical markers associated with neuronal damage.

Full description

For the purpose of this study, 30 patients undergoing aortic surgery via a median sternotomy (n=29; 97%) or left thoracotomy (n=1; 3%) and cardiopulmonary bypass with deep hypothermic cardiac arrest were recruited. All patients were operated under deep hypothermia and circulatory arrest, with optional selective cerebral perfusion during circulatory arrest. Active patient recruitment started from September 2007 and ended in May 2011. All patients were monitored with a bilateral fronto-temporal four channel abbreviated EEG, a bilateral frontal two-channel near-infrared spectroscopy, postoperative transcranial Doppler ultrasound evaluation of median artery circulation and postoperative biochemical neuromarkers. The study montage was set up by a dedicated research nurse, who also performed the transcranial Doppler measurements. The neuromonitoring data were not used at the time to guide therapeutic decisions, with the exception of near-infrared spectroscopy monitoring.

Enrollment: 61 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients scheduled for elective or emergency surgery on the thoracic aorta (study group) or coronary heart disease (control groups)
• Informed consent from patient or next of kin

Exclusion criteria

• Age under 18 years

Trial design

61 participants in 3 patient groups

Study group

Description:

Elective and emergency surgery for aneurysm or dissections of the ascending aorta, operated under extracorporeal circulation, protective deep therapeutic hypothermia and circulatory arrest.

On-pump CABG Group

Description:

Elective coronary artery bypass grafting (CABG) for coronary heart disease under extracorporeal circulation

OPCAB Group

Description:

Elective coronary artery bypass grafting (CABG) for coronary heart disease with a beating heart