title: Short-term outcome of attention and executive functions from aorta no-touch and traditional off-pump coronary artery bypass surgery.
abstract: OBJECTIVE
  Postoperative cognitive dysfunction (POCD) is an important neuropsychiatric complication of coronary artery bypass grafting (CABG). It is most likely caused by microembolic brain damage and affects domains of attention, memory, executive functions and dexterity. In order to achieve better neuroprotection, surgeons introduced some advantageous operating procedures. Noteworthy among them is a state-of-the-art off-pump CABG aorta no-touch technique ("no touch" OPCABG). The aim of this study was to investigate the short-term effect of "no touch" OPCABG on patients' attention and executive functions.
  
  
  METHODS
  In this prospective, observational, single-surgeon trial, 74 patients scheduled for elective CABG were studied. Thirty-five patients underwent "no-touch" OPCABG and were compared to 39 patients who underwent "traditional" OPCABG. Subjects underwent neurological and neuropsychological evaluation at the time of admission (7 ± 2 days preoperatively) and discharge (7 days postoperatively).
  
  
  RESULTS
  Patients who underwent "traditional" OPCABG showed a significant decline in postoperative performance on 4 neuropsychological tests, while patients treated with "no touch" OPCABG showed a significant decline on 1 test. Twenty patients from "traditional" OPCABG group and ten patients from "no touch" OPCABG group were diagnosed with POCD.
  
  
  CONCLUSIONS
  Use of "no touch" OPCABG was associated with better attention and executive functions 1 week after surgery compared with "traditional" OPCABG.
authors.affiliation: Department of Clinical Neuropsychology, Nicolaus Copernicus University, Collegium Medicum , Bydgoszcz , Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Szwed
authors.forename: Wojciech
authors.initials: W
authors.lastname: Pawliszak
authors.forename: Lech
authors.initials: L
authors.lastname: Anisimowicz
authors.forename: Adam
authors.initials: A
authors.lastname: Buciński
authors.forename: Alina
authors.initials: A
authors.lastname: Borkowska
mesh_terms: D000368:Aged; D001288:Attention / Q000502:physiology; D003072:Cognition Disorders / Q000209:etiology*; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects* / Q000379:methods; D056344:Executive Function / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D011446:Prospective Studies; D016896:Treatment Outcome
keywords: Coronary artery disease; brain injuries; cardiac surgical procedures; complications; neuropsychology