[Risk factors for neurological complications in the late period after operations on the ascending aortic arch].

Objective: To assess the risk factors for unfavorable neurological outcomes in the long-term follow-up periods (after 5 and 10 years) in patients undergoing planned operations on the ascending and arch of the aorta.

Material And Methods: The prospective study included 100 patients who were operated on at the FSBSI Petrovsky Russian Research Center of Surgery and were observed over a long period of time (up to 10 years). Patients of group I (=50) underwent surgery on the aortic arch with antegrade cerebral perfusion and hypothermic circulatory arrest (26 °C). Patients of group II (=50) underwent prosthetics of the ascending aorta with extracorporeal circulation with moderate hypothermia (32 °C). All patients performed cognitive tests before and after surgery, as well as 5 and 10 years after reconstruction. Possible risk factors were analyzed with respect to 3 expected negative consequences: postoperative delirium, neurocognitive dysfunction and long-term neurological disorders after 5 and 10 years of follow-up.

Results: Long-term cognitive impairments were statistically significantly associated with the following predictors: age, baseline presence of mild cognitive impairment, episodes of intraoperative microembolism, episodes of decreased cerebral perfusion, and delirium. The presence of short-term cognitive impairments in the immediate postoperative period was a significant risk factor for detecting impairments 5 and 10 years after surgery.

Conclusion: For the possibility of preventing long-term unfavorable outcomes of the intellectual sphere, the main attention should be directed to the dynamics of the patient's neurological state in the immediate postoperative period.