Early neurobehavioral disorders after cardiac surgery: a comparative analysis of coronary artery bypass graft surgery and valve replacement.
OBJECTIVE
To analyze neurobehavioral disorders in the early postoperative period after valve replacement and coronary artery bypass graft (CABG) surgery.


METHODS
Prospective study.


METHODS
University hospital.


METHODS
Patients undergoing elective cardiac surgery with cardiopulmonary bypass; 42 patients in the valve replacement surgery group and 42 patients in the CABG surgery group, with both groups matched post hoc for age, sex, and preoperative cognitive status.


RESULTS
All subjects were investigated preoperatively as well as 2 and 7 days postoperatively with a comprehensive neuropsychologic and neuropsychiatric assessment. The groups did not significantly differ with respect to the incidence of postoperative neuropsychiatric disorders. Valve replacement surgery patients exhibited more severe neuropsychologic deficits and showed a slower recovery than patients who underwent CABG surgery. In both groups, postoperative neuropsychologic alterations were most marked in fluency, arithmetic, and memory performance.


CONCLUSIONS
These results indicate that patients after valve replacement surgery have a higher risk of postoperative neuropsychologic alterations mainly attributable to temporal lobe dysfunction. This finding corresponds to a specific vulnerability of hippocampal structures to transient hypoxia.
Department of Thoracic and Cardiovascular Surgery, Otto-von-Guericke-University, Magdeburg, Germany.
A D
AD
Ebert
T A
TA
Walzer
C
C
Huth
M
M
Herrmann
D000328:Adult; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000523:psychology*; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000523:psychology*; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000209:etiology* / Q000523:psychology*; D009483:Neuropsychological Tests; D011184:Postoperative Period; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors