Cognitive function after on or off pump coronary artery bypass grafting.
OBJECTIVE
To investigate cognitive outcome after on and off pump coronary artery bypass grafting.


METHODS
Seventy patients between 50 and 80 years with stable angina pectoris, ejection fraction >30%, serum creatinine <150 micromol/l, and lack of tight main stem stenosis were randomized to on or off pump coronary artery bypass grafting. Standardized neuropsychological tests evaluated attention, verbal and visuo-spatial short-term and working memory, verbal learning, delayed recall, visuo-motor speed, and aspects of executive functions. Levels of anxiety and depression were also investigated. Testing was performed before and at 1 week, 1 and 6 months after surgery.


RESULTS
There was no difference in cognitive impairment (defined as a 20% reduction in at least 20% of the tests) between groups. The incidence at 1 week post-operatively was 57% in the on pump group and 58% in the off pump group, after 1 month 30% and 12% and after 6 months 19% and 15%, respectively (p for interaction=0.19). There was no difference between groups in anxiety (p=0.18) or depression (p=0.48).


CONCLUSIONS
This prospective, randomized study showed no differences in post-operative cognitive function after on pump compared to off pump coronary artery bypass grafting in low risk patients.
Vedin
Jenny
J
Department of Cardiothoracic Surgery and Anesthesia, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden. jenny.vedin@karolinska.se
Nyman
Håkan
H
Ericsson
Anders
A
Hylander
Susanne
S
Vaage
Jarle
J
D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D001026:Coronary Artery Bypass / Q000379:methods / Q000523:psychology*; D047549:Coronary Artery Bypass, Off-Pump / Q000523:psychology; D023921:Coronary Stenosis / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011446:Prospective Studies