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The Journal of Thoracic and Cardiovascular Surgery, Vol 98, 774-782, Copyright © 1989 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
BD Townes, G Bashein, TF Hornbein, DB Coppel, DE Goldstein, KB Davis, ML Nessly, SW Bledsoe, RC Veith and TD Ivey
To assess the severity and duration of new organic brain dysfunction after
cardiac operations, we used an extensive battery of neuropsychologic tests
to evaluate 65 patients undergoing coronary artery bypass grafting and 25
patients undergoing intracardiac operations with cardiopulmonary bypass.
Patients were tested the day before the operation, before discharge from
the hospital, and approximately 7 months later. Compared to 47 nonsurgical
control subjects tested at comparable time intervals, surgical subjects
showed generalized impairment of neuropsychologic abilities near the time
of discharge from the hospital. At follow-up testing, there was no evidence
of residual impairment among the surgically treated patients as a whole. In
fact, they showed greater improvement compared to initial test scores than
did control subjects. However, performance of 10 patients (11%) declined on
half of the neuropsychologic variables between preoperative and follow-up
testing. Neurobehavioral outcome was not related to the type of operation
(coronary bypass versus intracardiac), to factors of cardiopulmonary bypass
(duration, aortic occlusion time, hypotension, arterial carbon dioxide
tension, minimum hematocrit value, minimum temperature). The only predictor
of negative outcome was advanced age. We conclude that, although
neurobehavioral impairment is common during hospitalization after cardiac
operations, the prognosis for eventual full recovery is favorable, although
less so among the elderly.
ARTICLES
Neurobehavioral outcomes in cardiac operations. A prospective controlled study
Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle 98195.
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 E. A Hessel II Review article : What's new in monitoring the coronary surgery patient? Perfusion, July 1, 1992; 7(3): 161 - 194. [Abstract] [PDF]
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