A comparison of neuropsychologic deficits after extracardiac and intracaradiac surgery

J Cardiothorac Vasc Anesth. 2001 Feb;15(1):9-14. doi: 10.1053/jcan.2001.20210.

Abstract

Objective: To compare the incidence of neuropsychologic deficits 1 week and 6 months after coronary artery bypass graft (CABG) surgery (extracardiac) and valve surgery with or without CABG surgery (intracardiac) using reliable change indices to define the incidence of neuropsychologic deficits.

Design: Prospective study.

Setting: Cardiac surgical unit in a university teaching hospital.

Participants: Patients scheduled for elective multiple-graft (> or =3 grafts) CABG surgery (n = 59), or elective valve surgery (with or without concomitant CABG surgery) (n = 50) and a matched sample of nonsurgical controls (n = 53).

Interventions: Neuropsychologic assessments were performed 1 day before surgery, 7 days and 6 months after surgery.

Measurements and main results: The 7-day assessment showed no significant differences between valve surgery patients and CABG surgery patients in the incidence of neuropsychologic deficits. When reassessed 6 months postoperatively, the valve group displayed a significantly higher incidence of deficits on the digit symbol test compared with the CABG group (valve 26.7% v CABG 6.8%). In the CABG group, there was a significant change in the incidence of deficits per patient from 7 days to 6 months (p = 0.03) that was not evident in the valve group.

Conclusion: There are some differences in the neuropsychologic outcome of extracardiac and intracardiac surgery. Patients undergoing isolated CABG surgery showed a greater reduction in the incidence of persisting deficits at 6 months than patients undergoing valve surgery with or without CABG surgery. This finding warrants further investigation, with particular attention to patients undergoing combined valve and coronary artery procedures.

Publication types

  • Clinical Trial
  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cardiac Surgical Procedures / adverse effects*
  • Cardiac Surgical Procedures / psychology*
  • Cognition Disorders / etiology*
  • Cognition Disorders / psychology*
  • Coronary Artery Bypass / adverse effects*
  • Coronary Artery Bypass / psychology*
  • Female
  • Heart Valves / surgery*
  • Humans
  • Male
  • Middle Aged
  • Neuropsychological Tests*
  • Prospective Studies
  • Reproducibility of Results
  • Time Factors