Bentall surgery is a major cardiac procedure involving replacement of the ascending aorta, aortic root, and aortic valve, typically requiring cardiopulmonary bypass (CPB) and sometimes deep hypothermic circulatory arrest (DHCA). Due to its complexity, it carries a significant risk of postoperative neurological complications including stroke and postoperative cognitive dysfunction (POCD).
This prospective observational study aims to evaluate the relationship between perioperative bilateral optic nerve sheath diameter (ONSD) measurements obtained by ultrasound and postoperative cognitive functions in patients undergoing elective Bentall surgery. ONSD is a non-invasive surrogate marker of intracranial pressure that can be measured at the bedside using ultrasound.
In addition to routine hemodynamic monitoring and cerebral oximetry (NIRS), bilateral ONSD will be measured at predefined intraoperative and postoperative time points. Cognitive function will be assessed using the Montreal Cognitive Assessment (MoCA) test preoperatively and postoperatively, and delirium will be evaluated using the CAM-ICU scale during ICU stay. The association between perioperative ONSD values and postoperative cognitive outcomes, extubation time, ICU stay, and neurological complications will be analyzed.
Eligibility
Sex
ALL
Min age
18 Years
Max age
80 Years
Healthy volunteers
No
Inclusion Criteria:
* Age between 18 and 80 years
* Scheduled for elective Bentall procedure
* Requiring cardiopulmonary bypass (CPB)
* Willing to participate and able to provide informed consent
* Able to complete the MoCA cognitive assessment test
Exclusion Criteria:
* Age below 18 or above 80 years
* Emergency Bentall surgery
* Pre-existing diagnosed cognitive impairment or dementia
* History of prior stroke or neurological disease
* Significant carotid artery stenosis
* Inability to complete the MoCA test (language barrier, illiteracy, visual or hearing impairment)
* Refusal to participate or inability to provide informed consent
* Patients with known psychiatric disorders
* Reoperation (redo surgery)
* Patients with severe renal or hepatic failure
Primary outcome measure(s)
Relationship between perioperative bilateral ONSD measurements and postoperative cognitive function — Preoperative baseline to postoperative hospital discharge at 30 days The Montreal Cognitive Assessment (MoCA) test will be administered preoperatively and after extubation and before hospital discharge to evaluate postoperative cognitive dysfunction (POCD). MoCA assesses multiple cognitive domains including memory, attention, executive function, and abstraction. The relationship between perioperative bilateral optic nerve sheath diameter (ONSD) measurements obtained by ultrasound and the change in MoCA scores will be analyzed to determine whether ONSD can serve as a predictive marker for postoperative cognitive dysfunction in patients undergoing Bentall surgery.This study will evaluate the relationship between changes in optical diameter and postoperative cognitive function. Whether any correlation exists will be assessed based on the study results.
Trial sites (1)
Facility
City
Region
Status
Bursa High Specialization Training and Research Hospital
Bursa
Yıldırım
Recruiting
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This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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