Neuropsychological outcomes after pulmonary endarterectomy using moderate hypothermia and periodic circulatory arrest

J Heart Lung Transplant. 2018 Jul;37(7):860-864. doi: 10.1016/j.healun.2018.02.007. Epub 2018 Feb 19.

Abstract

Background: In this prospective, single-center, observational study, we investigated the association between repeated short periods of circulatory arrest with moderate hypothermia during pulmonary endarterectomy (PEA) in patients with chronic thromboembolic pulmonary hypertension (CTEPH) and different neuropsychological dimensions.

Methods: We examined 70 patients with CTEPH, >18 to 80 years of age, who had been treated with PEA. Neuropsychological testing was performed.

Results: Learning ability and delayed memory remained well within the normal range for patients' age. We found a statistically significant post-surgical improvement in motor speed, which was accompanied by a better quality of life and reduced symptoms of depression and anxiety.

Conclusion: PEA with repeated short periods of circulatory arrest in CTEPH did not result in any neuropsychological complications and may even lead to post-surgical psychological improvements.

Keywords: chronic thromboembolic pulmonary hypertension; circulatory arrest; moderate hypothermia; neuropsychological dimensions; pulmonary endarterectomy.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Combined Modality Therapy
  • Endarterectomy / methods
  • Endarterectomy / psychology*
  • Female
  • Heart Arrest, Induced / methods
  • Heart Arrest, Induced / psychology*
  • Humans
  • Hypertension, Pulmonary / complications
  • Hypertension, Pulmonary / therapy*
  • Hypothermia, Induced / methods
  • Hypothermia, Induced / psychology*
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Prospective Studies
  • Pulmonary Artery / surgery*
  • Thromboembolism / complications
  • Thromboembolism / therapy*
  • Time Factors
  • Treatment Outcome
  • Young Adult