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Is cardiopulmonary bypass still the cause of cognitive dysfunction after cardiac operations?

Taggart, D. P., Browne, S. M., Halligan, Peter and Wade, D. T. 1999. Is cardiopulmonary bypass still the cause of cognitive dysfunction after cardiac operations? The Journal of Thoracic and Cardiovascular Surgery 118 (3) , pp. 414-420. 10.1016/S0022-5223(99)70177-7

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Abstract

Objective: The purpose of this study was to determine whether cognitive impairment is related to cardiopulmonarybypass. Methods: Twenty-five patients undergoing coronary artery bypass grafting without cardiopulmonarybypass were matched with 50 patients undergoing coronary artery bypass grafting with cardiopulmonarybypass. All patients received the same anesthetic regimen, and one surgeon performed all the operations. A battery of 10 standard tests of neuropsychologic function were performed before, at discharge, and 3 months after the operation. A comprehensive multidimensional measure of subjective health status was used as the primary clinical measure of functional outcome. Results: The groups were similar with respect to age, sex, and ventricular function and differed only in the need for a circumflex artery graft. Both groups showed significant improvement in the comprehensive multidimensional measure of subjective health status at 3 months. At discharge most neuropsychologic tests had deteriorated in both groups (the same 4 tests had deteriorated significantly in both groups, and an additional test had deteriorated significantly in the cardiopulmonarybypass group). At 3 months all but one test in the cardiopulmonarybypass group had returned to or exceeded baseline performance. The same 2 tests had improved significantly in both groups, and a further test had improved significantly in the group without cardiopulmonarybypass. At no specific time point was there a significant difference between the absolute or change scores between the groups on any of the tests. Conclusions: The similar pattern of early decline and late recovery of cognitive function in patients undergoing coronary artery bypass grafting with and without cardiopulmonarybypass suggests that cardiopulmonarybypass is not the major cause of postoperative cognitive impairment. This merits consideration in deciding optimal treatment strategies in coronary revascularization. (J Thorac Cardiovasc Surg 1999;118: 414-21)

Item Type: Article
Date Type: Publication
Status: Published
Schools: Psychology
Subjects: B Philosophy. Psychology. Religion > BF Psychology
R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
R Medicine > RD Surgery
Publisher: Elsevier
ISSN: 0022-5223
Last Modified: 04 Jun 2017 04:14
URI: http://orca.cf.ac.uk/id/eprint/35228

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