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Transcerebral platelet activation after aortic cross-clamp release is linked to neurocognitive decline.

Publication ,  Journal Article
Mathew, JP; Rinder, HM; Smith, BR; Newman, MF; Rinder, CS
Published in: Ann Thorac Surg
May 2006

BACKGROUND: Neurocognitive decline after cardiac surgery requiring cardiopulmonary bypass (CPB) may be caused in part by highly prothrombotic atheroemboli to the brain; the source of these emboli is likely the ascending aorta and aortic arch. We examined transcerebral platelet activation gradients using simultaneous measurements in arterial and jugular venous blood and then compared gradients with post-CPB-associated neurocognitive injury. METHODS: Eighty-one patients undergoing elective coronary artery bypass graft surgery requiring CPB were studied. Neurocognitive function was measured preoperatively and again at 6 weeks postoperatively. Paired arterial and jugular venous blood samples were drawn before surgery, immediately before and after aortic cross-clamp removal (an event previously linked to embolic showers), and at the end of the operation. Transcerebral platelet activation gradients (venous minus arterial values) were compared in patients with and without cognitive deficit. RESULTS: Immediately after aortic cross-clamp removal, there was a significant increase in the transcerebral platelet activation gradient (increased % P-selectin-positive platelets during transcerebral passage) in the subset of patients who subsequently developed post-CPB cognitive deficit; this platelet activation gradient did not occur in patients without cognitive injury. In contrast, there was no transcerebral gradient of platelet activation in CPB patients as an entirety, nor was there a gradient at all other time points in the patient subset who went on to have cognitive deficit develop. This fleeting gradient of transcerebral platelet activation after cross-clamp removal was also significantly correlated with the overall change in cognitive injury score. CONCLUSIONS: Transient intracerebral platelet activation after removal of the aortic cross-clamp is associated with post-CPB neurocognitive injury.

Duke Scholars

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

May 2006

Volume

81

Issue

5

Start / End Page

1644 / 1649

Location

Netherlands

Related Subject Headings

  • Respiratory System
  • Prospective Studies
  • Platelet Activation
  • P-Selectin
  • Neuropsychological Tests
  • Middle Aged
  • Male
  • Humans
  • Female
  • Coronary Artery Bypass
 

Citation

APA
Chicago
ICMJE
MLA
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Mathew, J. P., Rinder, H. M., Smith, B. R., Newman, M. F., & Rinder, C. S. (2006). Transcerebral platelet activation after aortic cross-clamp release is linked to neurocognitive decline. Ann Thorac Surg, 81(5), 1644–1649. https://doi.org/10.1016/j.athoracsur.2005.12.070
Mathew, Joseph P., Henry M. Rinder, Brian R. Smith, Mark F. Newman, and Christine S. Rinder. “Transcerebral platelet activation after aortic cross-clamp release is linked to neurocognitive decline.Ann Thorac Surg 81, no. 5 (May 2006): 1644–49. https://doi.org/10.1016/j.athoracsur.2005.12.070.
Mathew JP, Rinder HM, Smith BR, Newman MF, Rinder CS. Transcerebral platelet activation after aortic cross-clamp release is linked to neurocognitive decline. Ann Thorac Surg. 2006 May;81(5):1644–9.
Mathew, Joseph P., et al. “Transcerebral platelet activation after aortic cross-clamp release is linked to neurocognitive decline.Ann Thorac Surg, vol. 81, no. 5, May 2006, pp. 1644–49. Pubmed, doi:10.1016/j.athoracsur.2005.12.070.
Mathew JP, Rinder HM, Smith BR, Newman MF, Rinder CS. Transcerebral platelet activation after aortic cross-clamp release is linked to neurocognitive decline. Ann Thorac Surg. 2006 May;81(5):1644–1649.
Journal cover image

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

May 2006

Volume

81

Issue

5

Start / End Page

1644 / 1649

Location

Netherlands

Related Subject Headings

  • Respiratory System
  • Prospective Studies
  • Platelet Activation
  • P-Selectin
  • Neuropsychological Tests
  • Middle Aged
  • Male
  • Humans
  • Female
  • Coronary Artery Bypass