[The effect of beating heart intracardiac procedures on postoperative cognitive function and S100b release: analysis of 51 patients].

Objective: To investigate the effect of beating heart intracardiac procedures on postoperative cognitive function and S100b release.

Methods: Fifty-one patients, aged 15 - 45, were divided into 2 groups to undergo intracardiac procedures under the conditions of cardiac arrest (n = 29, including 14 isolated valve replacement patients and 14 interauricular or interventricular septum repair patients) or beating heart (n = 23, all undergoing interauricular or interventricular septum repair). Before the operation and 7 days after the operation, a battery of neuropsychological tests, using trail making test, Wechsler memory scale, and Wechsler adult intelligence scale, was conducted. Forty healthy sex and age-matched volunteers underwent the same neuropsychological tests. The cognitive function impairment was evaluated by calculating the modified reliable change indices (MRCI). Cognitive function impairment in 2 or more items of the tests was defined as postoperative cognitive dysfunction (POCD. Blood samples were collected preoperatively and 24 h after cardiac surgery to measure the serum S100b by ELISA.

Results: The incidence of POCD in the arrested heart group was 42.9%, not significantly different from that of the beating heart group (34.8%, P > 0.05). The concentration of serum S100b 24 hours after cardiac surgery of the beating heart group was 0.37 +/- 0.17 microg/L, not ignorantly different from that of the arrested heart group (0.35 +/- 0.18 microg/L, P > 0.05).

Conclusion: Beating heart intracardiac procedures does not decrease the incidence of early cognitive dysfunction after cardiac surgery, and does not reduce the release of S100b.