title: Short-term and long-term neurocognitive outcome in on-pump versus off-pump CABG.
abstract: OBJECTIVE
  Neuropsychological dysfunctions are considered to be important complications of coronary artery bypass graft surgery (CABG). We examined the frequency of neuropsychological abnormalities occurring in patients undergoing CABG with (on-pump) and without (off-pump) cardiopulmonary bypass.
  
  
  METHODS
  Neuropsychological assessment with seven cognitive tasks was performed one day before, 6-7 days after (n=49) and 6 months after (n=35) surgery. The subgroup undergoing on-pump surgery (n=30 at 7 days and n=22 at 6 months) was demographically comparable to the off-pump subgroup. The on-pump group included more multiple vessel disease.
  
  
  RESULTS
  Repeated measures multivariate analysis of variance (using surgical group as a between-subjects factor) on the group data revealed no significant differences neither immediately after surgery nor at 6 months after surgery, compared with the preoperative performance. There were no significant differences between the on-pump and off-pump groups in post-operative neuropsychological performance soon after surgery. A significant difference was found between the two groups 6 months after surgery, with more favorable results for the off-pump group. Individual comparisons revealed that 59% of the patients of both groups undergoing CABG showed evidence of cognitive impairment soon after surgery. In 11% of the patients (all on-pump), the cognitive sequelae persisted at follow-up.
  
  
  CONCLUSIONS
  This study showed no short-term difference between the on-pump and off-pump CABG groups. The long-term cognitive outcome revealed more favorable results for the off-pump group. Although a preference to operate multiple vessel disease with classical cardiopulmonary bypass (CPB) has to be considered, the present study shows evidence for a different pattern of early decline and late recovery of cognitive functions in patients undergoing CABG with and without CPB.
authors.affiliation: Center for Cardiac Surgery, Ghent University Hospital, Ghent, Belgium. nathalie.stroobant@rug.ac.be
authors.forename: Nathalie
authors.initials: N
authors.lastname: Stroobant
authors.forename: Guido
authors.initials: G
authors.lastname: Van Nooten
authors.forename: Yves
authors.initials: Y
authors.lastname: Belleghem
authors.forename: Guy
authors.initials: G
authors.lastname: Vingerhoets
mesh_terms: D000368:Aged; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D001026:Coronary Artery Bypass / Q000379:methods*; D003327:Coronary Disease / Q000523:psychology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009483:Neuropsychological Tests