Neuropsychological functioning 3-5 years after coronary artery bypass grafting: does the pump make a difference?
OBJECTIVE
Neurocognitive sequelae after coronary artery bypass grafting (CABG) are frequently reported. The present study investigated the possible difference between on- and off-pump CABG patients in a long-term perspective.


METHODS
We administered seven standardized neuropsychological tests 1 day before, 6 days after, 6 months after and 3-5 years after CABG. We measured intra-operative high intensity transient signals (HITS) as a reflection of embolic load by transcranial Doppler ultrasonography.


RESULTS
Of the 74 patients originally recruited, 54 of the patients (73%) (mean age 59 years+/-7.5 years) completed the neuropsychological battery. Cognitive decline was defined as 20% decline on two or more tests. Three to 5 years after the operation, 30% of the patients showed neurocognitive problems in domains of non-verbal immediate memory and attention, speed for visual search, visual attention and mental flexibility. Neither difference in frequency of cognitive dysfunction nor a difference in evolution over the 5 year time period between on- and off-pump patients was observed. No significant predictors for cognitive decline were found.


CONCLUSIONS
Three to 5 years after the CABG surgery no difference in neurocognitive deficits is found between on- and off-pump CABG patients, indicating that the extracorporeal circulation (ECC) may not be the main cause of late neuropsychological decline.
Centre for Cardiac Surgery, University Hospital Ghent, De Pintelaan 185, Ghent, Belgium. Nathalie.Stroobant@ugent.be
Nathalie
N
Stroobant
Guido
G
van Nooten
Dirk
D
De Bacquer
Yves
Y
Van Belleghem
Guy
G
Vingerhoets
D000367:Age Factors; D000368:Aged; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D003072:Cognition Disorders / Q000209:etiology*; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000379:methods; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007360:Intelligence; D020766:Intracranial Embolism / Q000000981:diagnostic imaging / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D018579:Patient Selection; D012307:Risk Factors; D017585:Ultrasonography, Doppler, Transcranial