**10. Conclusions**

According to the results of our study, cardiovascular aortic valve surgery has similar incidence of postoperative NC when compared with bypass surgery or combined surgeries. The risk factors in order of importance were: a history of arterial hypertension, heart failure, dyslipidemia, having a previous stroke and being a smoker.

NCs after aortic valve surgery have been associated with increased morbidity and mortality, with increased hospitalization time and rehabilitation costs, and they thus contribute to decreased quality of life. The incidence of NCs has remained unchanged in recent years, despite increasing age and comorbidity. The improvement in technical advances has contributed to keeping these percentages up.

Although most complications can be associated with cardiopulmonary bypass, other factors are also involved. Identifying high-risk patients may reduce the incidence of complications in high risk groups, but this seems to be a poor prevention strategy.

In an increasingly aging population and with a growing number of diseases, prevention strategies should focus on three aspects: firstly, technical improvements in cardiac surgery and cerebral protection, secondly, identifying reliable techniques to assess neuropsychological dysfunction after cardiac surgery, and finally carrying out technical training in rehabilitation to avoid or minimize the side effects as a result of NCs arising from aortic surgery.

#### **11. References**

Arauz-Góngora AA, Souta-Meiriño CA, Cotter-Lemus LE, Guzman-Rodriguez C, Méndez Dominguez A. The neurological complications of infectus endocarditis. Arch Inst Cardiol Mex. 1998 68(4): 328-32

similar to other work associated with the incidence of endocarditis (Arauz-Gongora et al,

The average times for aortic clamping and CPB were 101 and 125.2 minutes respectively. This is somewhat higher in some of the surgeries with more NCs such as in 2nd valve replacement, followed by multiple valve replacement and aortic arch replacement (Bentall).

Overall mortality was 1.7% and in no way associated with cases of stroke, or with patients who suffered acute confusional state. There were, however, two deaths of patients with hypoxi-ischemic encephalopathy and multiple causes. These results are similar to other publications. However, in our work the appearance of a neurological complication did not significantly increase mortality (Redmond et al, 1996). There are groups with no mortality

The length of hospital stay increases dramatically when there are NCs, as evidenced in other

The data provided in connection with rehabilitation techniques carried out fall far short because many patients were referred to another hospital area in Madrid or another province

This study is limited mainly in that it is a retrospective study and this prevents us from knowing the exact time of the onset of the NC and therefore we cannot draw valid conclusions regarding the type of NC, the rehabilitation treatment carried out and the

According to the results of our study, cardiovascular aortic valve surgery has similar incidence of postoperative NC when compared with bypass surgery or combined surgeries. The risk factors in order of importance were: a history of arterial hypertension, heart failure,

NCs after aortic valve surgery have been associated with increased morbidity and mortality, with increased hospitalization time and rehabilitation costs, and they thus contribute to decreased quality of life. The incidence of NCs has remained unchanged in recent years, despite increasing age and comorbidity. The improvement in technical advances has

Although most complications can be associated with cardiopulmonary bypass, other factors are also involved. Identifying high-risk patients may reduce the incidence of complications

In an increasingly aging population and with a growing number of diseases, prevention strategies should focus on three aspects: firstly, technical improvements in cardiac surgery and cerebral protection, secondly, identifying reliable techniques to assess neuropsychological dysfunction after cardiac surgery, and finally carrying out technical training in rehabilitation

Arauz-Góngora AA, Souta-Meiriño CA, Cotter-Lemus LE, Guzman-Rodriguez C, Méndez

Dominguez A. The neurological complications of infectus endocarditis. Arch Inst

to avoid or minimize the side effects as a result of NCs arising from aortic surgery.

although the number of patients is lower (n=118) (Mutarelli EG et al, 1993).

of Spain and continued the rehabilitation in places near their original home.

dyslipidemia, having a previous stroke and being a smoker.

in high risk groups, but this seems to be a poor prevention strategy.

contributed to keeping these percentages up.

Cardiol Mex. 1998 68(4): 328-32

1998).

Table 4.

works. Table 5.

prognosis.

**10. Conclusions** 

**11. References** 


**Part 6** 

**Congenital Anomaly Application** 

