HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Vingerhoets, G. Articles by Jannes, C. Search for Related Content PubMed PubMed Citation Articles by Vingerhoets, G. Articles by Jannes, C.

European Journal of Cardio-Thoracic Surgery, Vol 11, 424-431, Copyright © 1997 by European Association for Cardio-thoracic Surgery

ARTICLES

Short-term and long-term neuropsychological consequences of cardiac surgery with extracorporeal circulation

G Vingerhoets, G Van Nooten, F Vermassen, G De Soete and C Jannes
Department of Psychiatry and Neuropsychology, University Hospital Gent, Belgium.

OBJECTIVE: Cognitive dysfunction after extracorporeal circulation is a major continuing problem in modern cardiac surgery. We designed this prospective study to update the incidence of postoperative neuropsychological changes after routine cardiopulmonary bypass (CPB) and to identify perioperative variables associated with these complications. METHODS: We assessed the patients with a comprehensive neuropsychological test battery 1 day before, 7 days after (n = 109) and 6 months after (n = 91) cardiopulmonary bypass. We used patients undergoing major vascular or thoracic surgery as a surgical control group (n = 20). RESULTS: Repeated measures multivariate analysis of variance (using surgical group as a between-subjects factor) on the group data revealed significant changes early after surgery compared with the preoperative performance (P = 0.001). The early changes are characterized by a significant decrease of visual attention and verbal memory performance (univariate F-tests, always P < 0.05). Cardiac patients showing cognitive impairment after cardiac surgery had lower preoperative ejection fractions (P = 0.014) and a more complicated medical history (P = 0.046). At 6-month follow-up, the patients performed significantly better than before surgery (P < 0.001). CPB patients showing persistent cognitive impairment at follow-up were significantly older at the time of surgery (P = 0.005). Individual comparisons revealed that 45% of the patients undergoing CPB showed evidence of cognitive impairment soon after surgery. In 12% of the patients, the cognitive sequelae persisted at follow-up. Both group data and individual incidence rates revealed neither significant pre- post differences between the surgical groups nor a time-by-group interaction effect. Variables directly associated with CPB were not significantly associated with the occurrence of cognitive impairment after surgery. CONCLUSIONS: We conclude that an important proportion of the cognitive impairment after cardiac surgery is likely to be due to nonspecific effects of surgery.

This article has been cited by other articles:

				J. S. Savino and A. T. Cheung Cardiac Anesthesia Card. Surg. Adult, January 1, 2008; 3(2008): 281 - 314. [Full Text]

				D. J. Cook, J. Huston III, M. R. Trenerry, R. D. Brown Jr, K. J. Zehr, and T. M. Sundt III Postcardiac Surgical Cognitive Impairment in the Aged Using Diffusion-Weighted Magnetic Resonance Imaging Ann. Thorac. Surg., April 1, 2007; 83(4): 1389 - 1395. [Abstract] [Full Text] [PDF]

				C. D. Hanning Postoperative cognitive dysfunction Br. J. Anaesth., July 1, 2005; 95(1): 82 - 87. [Full Text] [PDF]

				K. G. Engstrom Contaminating fat in pericardial suction blood: a clinical, technical and scientific challenge Perfusion, January 1, 2004; 19(1_suppl): S21 - S31. [Abstract] [PDF]

				J. E. Scarborough, W. White, F. E. Derilus, J. P. Mathew, M. F. Newman, and K. P. Landolfo Combined use of off-pump techniques and a sutureless proximal aortic anastomotic device reduces cerebral microemboli generation during coronary artery bypass grafting J. Thorac. Cardiovasc. Surg., November 1, 2003; 126(5): 1561 - 1567. [Abstract] [Full Text] [PDF]

				E. Ahlgren, A. Lundqvist, A. Nordlund, C. Aren, and H. Rutberg Neurocognitive impairment and driving performance after coronary artery bypass surgery Eur. J. Cardiothorac. Surg., March 1, 2003; 23(3): 334 - 340. [Abstract] [Full Text] [PDF]

				J. S. Savino, T. F. Floyd, and A. T. Cheung Cardiac Anesthesia Card. Surg. Adult, January 1, 2003; 2(2003): 249 - 281. [Full Text]

				V. Zamvar, D. Williams, J. Hall, N. Payne, C. Cann, K. Young, S Karthikeyan, and J. Dunne Assessment of neurocognitive impairment after off-pump and on-pump techniques for coronary artery bypass graft surgery: prospective randomised controlled trial BMJ, November 30, 2002; 325(7375): 1268 - 1268. [Abstract] [Full Text] [PDF]

				R. P. Alston, K. Yoshitani, M. Kawaguch, H. Furuya, and N. Kurumatani Cerebral Oxygenation and Cognitive Decline Anesth. Analg., December 1, 2001; 93(6): 1628 - 1628. [Full Text] [PDF]

				W. Wandschneider, M. Thalmann, E. Trampitsch, G. Ziervogel, and G. Kobinia Off-pump coronary bypass operations significantly reduce S100 release: an indicator for less cerebral damage? Ann. Thorac. Surg., November 1, 2000; 70(5): 1577 - 1579. [Abstract] [Full Text] [PDF]

				M. Herrmann, A. D. Ebert, I. Galazky, M. T. Wunderlich, W. S. Kunz, and C. Huth Neurobehavioral Outcome Prediction After Cardiac Surgery : Role of Neurobiochemical Markers of Damage to Neuronal and Glial Brain Tissue Stroke, March 1, 2000; 31(3): 645 - 650. [Abstract] [Full Text] [PDF]

				D. Georgiadis, A. Berger, E. Kowatschev, C. Lautenschlager, A. Borner, A. Lindner, W. Schulte-Mattler, H.-R. Zerkowski, S. Zierz, and T. Deufel PREDICTIVE VALUE OF S-100{beta} AND NEURON-SPECIFIC ENOLASE SERUM LEVELS FOR ADVERSE NEUROLOGIC OUTCOME AFTER CARDIAC SURGERY J. Thorac. Cardiovasc. Surg., January 1, 2000; 119(1): 138 - 147. [Abstract] [Full Text] [PDF]

				D. P. Taggart, S. M. Browne, P. W. Halligan, and D. T. Wade IS CARDIOPULMONARY BYPASS STILL THE CAUSE OF COGNITIVE DYSFUNCTION AFTER CARDIAC OPERATIONS? J. Thorac. Cardiovasc. Surg., September 1, 1999; 118(3): 414 - 420. [Abstract] [Full Text] [PDF]

				J. Butterworth Ann. Thorac. Surg., April 1, 1999; 67(4): 1124 - 1124. [Full Text] [PDF]