Neurological outcome after minimally invasive coronary artery bypass surgery (NOMICS): An observational prospective cohort study.
<h4>Background/objectives</h4>Endoscopic coronary artery bypass grafting (Endo-CABG) is a minimally invasive CABG procedure with retrograde arterial perfusion. The main objective of this study is to assess neurocognitive outcome after Endo-CABG.<h4>Methods/design</h4>In this...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2020-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0242519 |
| _version_ | 1819291948115034112 |
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| author | Björn Stessel Kristof Nijs Caroline Pelckmans Jeroen Vandenbrande Jean-Paul Ory Alaaddin Yilmaz Pascal Starinieri Michiel Van Tornout Nina De Klippel Paul Dendale |
| author_facet | Björn Stessel Kristof Nijs Caroline Pelckmans Jeroen Vandenbrande Jean-Paul Ory Alaaddin Yilmaz Pascal Starinieri Michiel Van Tornout Nina De Klippel Paul Dendale |
| author_sort | Björn Stessel |
| collection | DOAJ |
| description | <h4>Background/objectives</h4>Endoscopic coronary artery bypass grafting (Endo-CABG) is a minimally invasive CABG procedure with retrograde arterial perfusion. The main objective of this study is to assess neurocognitive outcome after Endo-CABG.<h4>Methods/design</h4>In this prospective observational cohort study, patients were categorised into: Endo-CABG (n = 60), a comparative Percutaneous Coronary Intervention (PCI) group (n = 60) and a healthy volunteer group (n = 60). A clinical neurological examination was performed both pre- and postoperatively, delirium was assessed postoperatively. A battery of 6 neurocognitive tests, Quality of life (QoL) and the level of depressive feelings were measured at baseline and after 3 months. Patient Satisfaction after Endo-CABG was assessed at 3-month follow-up. Primary endpoints were incidence of postoperative cognitive dysfunction (POCD), stroke and delirium after Endo-CABG. Secondary endpoints were QOL, patient satisfaction and the incidence of depressive feelings after Endo-CABG.<h4>Results</h4>In total, 1 patient after Endo-CABG (1.72%) and 1 patient after PCI (1.67%) suffered from stroke during the 3-month follow-up. POCD in a patient is defined as a Reliable Change Index ≤-1.645 or Z-score ≤-1.645 in at least two tests, and was found in respectively 5 and 6 patients 3 months after Endo-CABG and PCI. Total incidence of POCD/stroke was not different (PCI: n= 7 [15.9%]; Endo-CABG: n= 6 [13.0%], p = 0.732). ICU delirium after Endo-CABG was found in 5 (8.6%) patients. QoL increased significantly three months after Endo-CABG and was comparable with QoL level after PCI and in the control group. Patient satisfaction after Endo-CABG and PCI was comparable. At follow-up, the level of depressive feelings was decreased in all groups.<h4>Conclusions</h4>The incidence of poor neurocognitive outcome, including stroke, POCD and postoperative ICU delirium until three months after Endo-CABG is low and comparable with PCI.<h4>Trial registration</h4>Registered on ClinicalTrials.gov (NCT02979782). |
| first_indexed | 2024-12-24T03:46:44Z |
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| id | doaj.art-8b8b8f2cfb7440a19658103bfd645f5a |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-24T03:46:44Z |
| publishDate | 2020-01-01 |
| publisher | Public Library of Science (PLoS) |
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| spelling | doaj.art-8b8b8f2cfb7440a19658103bfd645f5a2022-12-21T17:16:42ZengPublic Library of Science (PLoS)PLoS ONE1932-62032020-01-011512e024251910.1371/journal.pone.0242519Neurological outcome after minimally invasive coronary artery bypass surgery (NOMICS): An observational prospective cohort study.Björn StesselKristof NijsCaroline PelckmansJeroen VandenbrandeJean-Paul OryAlaaddin YilmazPascal StarinieriMichiel Van TornoutNina De KlippelPaul Dendale<h4>Background/objectives</h4>Endoscopic coronary artery bypass grafting (Endo-CABG) is a minimally invasive CABG procedure with retrograde arterial perfusion. The main objective of this study is to assess neurocognitive outcome after Endo-CABG.<h4>Methods/design</h4>In this prospective observational cohort study, patients were categorised into: Endo-CABG (n = 60), a comparative Percutaneous Coronary Intervention (PCI) group (n = 60) and a healthy volunteer group (n = 60). A clinical neurological examination was performed both pre- and postoperatively, delirium was assessed postoperatively. A battery of 6 neurocognitive tests, Quality of life (QoL) and the level of depressive feelings were measured at baseline and after 3 months. Patient Satisfaction after Endo-CABG was assessed at 3-month follow-up. Primary endpoints were incidence of postoperative cognitive dysfunction (POCD), stroke and delirium after Endo-CABG. Secondary endpoints were QOL, patient satisfaction and the incidence of depressive feelings after Endo-CABG.<h4>Results</h4>In total, 1 patient after Endo-CABG (1.72%) and 1 patient after PCI (1.67%) suffered from stroke during the 3-month follow-up. POCD in a patient is defined as a Reliable Change Index ≤-1.645 or Z-score ≤-1.645 in at least two tests, and was found in respectively 5 and 6 patients 3 months after Endo-CABG and PCI. Total incidence of POCD/stroke was not different (PCI: n= 7 [15.9%]; Endo-CABG: n= 6 [13.0%], p = 0.732). ICU delirium after Endo-CABG was found in 5 (8.6%) patients. QoL increased significantly three months after Endo-CABG and was comparable with QoL level after PCI and in the control group. Patient satisfaction after Endo-CABG and PCI was comparable. At follow-up, the level of depressive feelings was decreased in all groups.<h4>Conclusions</h4>The incidence of poor neurocognitive outcome, including stroke, POCD and postoperative ICU delirium until three months after Endo-CABG is low and comparable with PCI.<h4>Trial registration</h4>Registered on ClinicalTrials.gov (NCT02979782).https://doi.org/10.1371/journal.pone.0242519 |
| spellingShingle | Björn Stessel Kristof Nijs Caroline Pelckmans Jeroen Vandenbrande Jean-Paul Ory Alaaddin Yilmaz Pascal Starinieri Michiel Van Tornout Nina De Klippel Paul Dendale Neurological outcome after minimally invasive coronary artery bypass surgery (NOMICS): An observational prospective cohort study. PLoS ONE |
| title | Neurological outcome after minimally invasive coronary artery bypass surgery (NOMICS): An observational prospective cohort study. |
| title_full | Neurological outcome after minimally invasive coronary artery bypass surgery (NOMICS): An observational prospective cohort study. |
| title_fullStr | Neurological outcome after minimally invasive coronary artery bypass surgery (NOMICS): An observational prospective cohort study. |
| title_full_unstemmed | Neurological outcome after minimally invasive coronary artery bypass surgery (NOMICS): An observational prospective cohort study. |
| title_short | Neurological outcome after minimally invasive coronary artery bypass surgery (NOMICS): An observational prospective cohort study. |
| title_sort | neurological outcome after minimally invasive coronary artery bypass surgery nomics an observational prospective cohort study |
| url | https://doi.org/10.1371/journal.pone.0242519 |
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