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Cardiac surgery is responsible for many complications. Microcirculation is involved in many of them. The objective of this study is to prospectively investigate the prognostic value of preoperative microcirculatory assessment in patients scheduled for cardiac surgery with CPB for the occurrence of postoperative complications.
Microvascular dysfunction is suspected of being involved in postoperative psycho-cognitive decline. The influence of microcirculation on the evolution of psycho-cognitive assessment is also analyzed in this study.
Eligible patients are included during the preoperative assessment. Written consent is signed after complete explanation of the protocol.
Patient characteristics as treatments, medical history, and EuroSCORE II are registered. Moreover, intraoperative data is collected. Psycho-cognitive and functional evaluation is made preoperatively.
Microcirculation is evaluated for each patient before surgery. Complications are registered at the end of hospital stay. Psycho-cognitive and functional evaluation is repeated by call 30 days after the surgery.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Microvascular reactivity evaluation | Experimental | Patients referred for a preoperative arterial palmar arches assessment before cardiac valvular or coronary surgery. Intervention is measurement of microvascular reactivity with a laser speckle contrast imaging before surgery. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Microvascular reactivity evaluation | Procedure | Microcirculation will be evaluated for each patient before surgery with a laser speckle contrast imaging (LSCI) placed on the forearm. Tests will be performed for evaluation of endothelium reactivity: Iontophoresis. |
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative complication | Composite criteria and include microcirculation postoperative complications:
| 30 postoperative days |
| Measure | Description | Time Frame |
|---|---|---|
| Evolution of degree of disability | Change of modified Rankin scale | Inclusion and 30 days after surgery |
| Functional evolution | Change of ADL score |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Samir HENNI, MD PhD | UH Angers | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| UH Angers | Angers | 49933 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 38424616 | Derived | Abrard S, Streichenberger A, Riou J, Hersant J, Rineau E, Jacquet-Lagreze M, Fouquet O, Henni S, Rimmele T. Preoperative endothelial dysfunction for the prediction of acute kidney injury after cardiac surgery using cardiopulmonary bypass: a pilot study based on a second analysis of the MONS study. Perioper Med (Lond). 2024 Feb 29;13(1):12. doi: 10.1186/s13741-024-00364-0. | |
| 33411095 |
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| Inclusion and 30 days after surgery |
| Mood evolution | Change of brief Geriatric Depression Scale | Inclusion and 30 days after surgery |
| Cognitive evolution | Change of Mc Nair test | Inclusion and 30 days after surgery |
| Derived |
| Abrard S, Fouquet O, Riou J, Rineau E, Abraham P, Sargentini C, Bigou Y, Baufreton C, Lasocki S, Henni S. Preoperative endothelial dysfunction in cutaneous microcirculation is associated with postoperative organ injury after cardiac surgery using extracorporeal circulation: a prospective cohort study. Ann Intensive Care. 2021 Jan 7;11(1):4. doi: 10.1186/s13613-020-00789-y. |