Cognitive and neurobehavioral dysfunction after cardiac bypass procedures.
From a cognitive standpoint, CABG as currently practiced appears to be safe for the great majority of patients, but transient changes involving memory, executive functions, and motor speed may still occur in a subset of patients during the first few days to weeks after CABG. The etiology most likely is multifactorial and includes a synergistic effect of microemboli, hypo-perfusion, and other variables associated with major surgery. Older age and degree of pre-existing cerebrovascular disease have been identified as important risk factors. The short-term cognitive changes appear to be reversible by 3 months after surgery for most patients. Late cognitive decline after CABG,occurring between 1 and 5 years after the surgery, has been well documented,but controlled studies demonstrating that this decline is specifically attributable to the use of cardiopulmonary bypass itself rather than to progression of underlying cerebrovascular disease or other age-related changes are pending.
Selnes
Ola A
OA
Department of Neurology, Division of Cognitive Neuroscience, Johns Hopkins University School of Medicine, Reed Hall East-2, 1620 McElderry Street, Baltimore, MD 21287, USA. oselnes@jhmi.edu
McKhann
Guy M
GM
Borowicz
Louis M
LM
Grega
Maura A
MA
D001281:Atrial Fibrillation / Q000150:complications / Q000453:epidemiology; D001921:Brain / Q000098:blood supply; D003072:Cognition Disorders / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000523:psychology; D003863:Depression / Q000209:etiology; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D012720:Severity of Illness Index