Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-14T13:24:51.677Z Has data issue: false hasContentIssue false
  • English
  • Français

Neuropsychological outcomes after coronary artery bypass grafting

Published online by Cambridge University Press:  11 December 2009

OLA A. SELNES  and
REBECCA F. GOTTESMAN
OLA A. SELNES*
Affiliation:
Cognitive Neuroscience Division, Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
REBECCA F. GOTTESMAN
Affiliation:
Cerebrovascular Division, Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
*
*Correspondence and reprint requests to: Ola A. Selnes, Division of Cognitive Neuroscience, Johns Hopkins University School of Medicine, 1620 McElderry Street, Reed Hall East – 2, Baltimore, MD 21205-2189. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Short- and long-term cognitive declines after cardiac surgery with cardiopulmonary bypass have been reported, but the frequency, severity, nature, and etiology of postoperative cognitive changes have been difficult to quantify. Current studies have corrected the principal methodological shortcoming of earlier studies by including control groups, and have shown that while early postoperative cognitive decline does occur in some patients, it is generally mild and reversible by 3 months after surgery. Late cognitive changes do occur, but comparison with patients undergoing off-pump surgery or those being treated medically suggests that these changes are not specific to CABG or more specifically to the use of cardiopulmonary bypass. (JINS, 2010, 16, 221–226.)

Keywords

Coronary artery diseaseOutcome assessmentPostoperative complicationsCognition disordersProspective studies
Type
Short Review
Information
Journal of the International Neuropsychological Society , Volume 16 , Issue 2 , March 2010 , pp. 221 - 226
Copyright
Copyright © The International Neuropsychological Society 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Andrew, M.J., Baker, R.A., Bennetts, J., Kneebone, A.C., & Knight, J.L. (2001). A comparison of neuropsychologic deficits after extracardiac and intracaradiac surgery. Journal of Cardiothoracic and Vascular Anesthesia, 15, 9–14.CrossRefGoogle ScholarPubMed
Anyanwu, A.C., Filsoufi, F., Salzberg, S.P., Bronster, D.J., & Adams, D.H. (2007). Epidemiology of stroke after cardiac surgery in the current era. Journal of Thoracic and Cardiovascular Surgery, 134, 1121–1127.CrossRefGoogle ScholarPubMed
Bergh, C., Backstrom, M., Jonsson, H., Havinder, L., & Johnsson, P. (2002). In the eye of both patient and spouse: Memory is poor 1 to 2 years after coronary bypass and angioplasty. Annals of Thoracic Surgery, 74, 689–693.CrossRefGoogle ScholarPubMed
Brown, W.R., Moody, D.M., Tytell, M., Ghazi-Birry, H.S., & Challa, V.R. (1997). Microembolic brain injuries from cardiac surgery: Are they seeds of future Alzheimer’s disease? Annals of the New York Academy of Sciences, 826, 386–389.CrossRefGoogle ScholarPubMed
Caplan, L.R., & Hennerici, M. (1998). Impaired clearance of emboli (washout) is an important link between hypoperfusion, embolism, and ischemic stroke. Archives of Neurology, 55, 1475–1482.CrossRefGoogle ScholarPubMed
Collison, T., Smith, J.M., & Engel, A.M. (2006). Peripheral vascular disease and outcomes following coronary artery bypass graft surgery. Archives of Surgery, 141, 1214–1218.CrossRefGoogle ScholarPubMed
Fearn, S.J., Pole, R., Wesnes, K., Faragher, E.B., Hooper, T.L., & McCollum, C.N. (2001). Cerebral injury during cardiopulmonary bypass: Emboli impair memory. Journal of Thoracic and Cardiovascular Surgery, 121, 1150–1160.CrossRefGoogle ScholarPubMed
Fitzpatrick, A.L., Kuller, L.H., Ives, D.G., Lopez, O.L., Jagust, W., Breitner, J.C. et al. (2004). Incidence and prevalence of dementia in the Cardiovascular Health Study. Journal of the American Geriatric Society, 52, 195–204.CrossRefGoogle ScholarPubMed
Goto, T., Baba, T., Honma, K., Shibata, Y., Arai, Y., Uozumi, H. et al. (2001). Magnetic resonance imaging findings and postoperative neurologic dysfunction in elderly patients undergoing coronary artery bypass grafting. Annals of Thoracic Surgery, 72, 137–142.CrossRefGoogle ScholarPubMed
Gottesman, R.F., Sherman, P.M., Grega, M.A., Yousem, D.M., Borowicz, L.M. Jr., Selnes, O.A. et al. (2006). Watershed strokes after cardiac surgery: Diagnosis, etiology, and outcome. Stroke, 37, 2306–2311.CrossRefGoogle ScholarPubMed
Ho, P.M., Arciniegas, D.B., Grigsby, J., McCarthy, M. Jr., McDonald, G.O., Moritz, T.E. et al. (2004). Predictors of cognitive decline following coronary artery bypass graft surgery. Annals of Thoracic Surgery, 77, 597–603.CrossRefGoogle ScholarPubMed
Hogue, C.W., Fucetola, R., Hershey, T., Freedland, K., vila-Roman, V.G., Goate, A.M. et al. (2008). Risk factors for neurocognitive dysfunction after cardiac surgery in postmenopausal women. Annals of Thoracic Surgery, 86, 511–516.CrossRefGoogle ScholarPubMed
Hogue, C.W. Jr., Hershey, T., Dixon, D., Fucetola, R., Nassief, A., Freedland, K.E. et al. (2006). Preexisting cognitive impairment in women before cardiac surgery and its relationship with C-reactive protein concentrations. Anesthesiology and Analgesia, 102, 1602–1608.CrossRefGoogle ScholarPubMed
Jensen, B.O., Rasmussen, L.S., & Steinbruchel, D.A. (2008). Cognitive outcomes in elderly high-risk patients 1 year after off-pump versus on-pump coronary artery bypass grafting. A randomized trial. European Journal of Cardio-Thoracic Surgery, 34, 1016–1021.CrossRefGoogle ScholarPubMed
Kneebone, A.C., Andrew, M.J., Baker, R.A., & Knight, J.L. (1998). Neuropsychologic changes after coronary artery bypass grafting: Use of reliable change indices. Annals of Thoracic Surgery, 65, 1320–1325.CrossRefGoogle ScholarPubMed
Kneebone, A.C., Luszcz, M.A., Baker, R.A., & Knight, J.L. (2005). A syndromal analysis of neuropsychological outcome following coronary artery bypass graft surgery. Journal of Neurological and Neurosurgical Psychiatry, 76, 1121–1127.CrossRefGoogle ScholarPubMed
Knopman, D.S., Petersen, R.C., Cha, R.H., Edland, S.D., & Rocca, W.A. (2005). Coronary artery bypass grafting is not a risk factor for dementia or Alzheimer disease. Neurology, 65, 986–990.CrossRefGoogle ScholarPubMed
Lee, T.A., Wolozin, B., Weiss, K.B., & Bednar, M.M. (2005). Assessment of the emergence of Alzheimer’s disease following coronary artery bypass graft surgery or percutaneous transluminal coronary angioplasty. Journal of Alzheimer’s Disease, 7, 319–324.CrossRefGoogle ScholarPubMed
Luchsinger, J.A., Reitz, C., Honig, L.S., Tang, M.X., Shea, S., & Mayeux, R. (2005). Aggregation of vascular risk factors and risk of incident Alzheimer disease. Neurology, 65, 545–551.CrossRefGoogle ScholarPubMed
Mahanna, E.P., Blumenthal, J.A., White, W.D., Croughwell, N.D., Clancy, C.P., Smith, L.R. et al. (1996). Defining neuropsychological dysfunction after coronary artery bypass grafting. Annals of Thoracic Surgery, 61, 1342–1347.CrossRefGoogle ScholarPubMed
McKhann, G.M., Grega, M.A., Borowicz, L.M. Jr., Baumgartner, W.A., & Selnes, O.A. (2006). Stroke and encephalopathy after cardiac surgery: An update. Stroke, 37, 562–571.CrossRefGoogle ScholarPubMed
Mullges, W., Berg, D., Schmidtke, A., Weinacker, B., & Toyka, K.V. (2000). Early natural course of transient encephalopathy after coronary artery bypass grafting. Critical Care Medicine, 28, 1808–1811.CrossRefGoogle ScholarPubMed
Newman, A.B., Fitzpatrick, A.L., Lopez, O., Jackson, S., Lyketsos, C., Jagust, W. et al. (2005). Dementia and Alzheimer’s disease incidence in relationship to cardiovascular disease in the Cardiovascular Health Study cohort. Journal of the American Geriatric Society, 53, 1101–1107.CrossRefGoogle ScholarPubMed
Newman, M.F., Croughwell, N.D., Blumenthal, J.A., Lowry, E., White, W.D., Spillane, W. et al. (1995). Predictors of cognitive decline after cardiac operation. Annals of Thoracic Surgery, 59, 1326–1330.CrossRefGoogle ScholarPubMed
Newman, M.F., Kirchner, J.L., Phillips-Bute, B., Gaver, V., Grocott, H., Jones, R.H. et al. (2001). Longitudinal assessment of neurocognitive function after coronary-artery bypass surgery. New England Journal of Medicine, 344, 395–402.CrossRefGoogle ScholarPubMed
Newman, S., Stygall, J., Hirani, S., Shaefi, S., & Maze, M. (2007). Postoperative cognitive dysfunction after noncardiac surgery: A systematic review. Anesthesiology, 106, 572–590.CrossRefGoogle ScholarPubMed
Raymond, P.D., Hinton-Bayre, A.D., Radel, M., Ray, M.J., & Marsh, N.A. (2006). Assessment of statistical change criteria used to define significant change in neuropsychological test performance following cardiac surgery. European Journal of Cardio-Thoracic Surgery, 29, 82–88.CrossRefGoogle ScholarPubMed
Selnes, O.A., Grega, M.A., Borowicz, L.M. Jr., Barry, S., Zeger, S., Baumgartner, W.A. et al. (2005). Cognitive outcomes three years after coronary artery bypass surgery: A comparison of on-pump coronary artery bypass graft surgery and nonsurgical controls. Annals of Thoracic Surgery, 79, 1201–1209.CrossRefGoogle ScholarPubMed
Selnes, O.A., Grega, M.A., Borowicz, L.M. Jr., Royall, R.M., McKhann, G.M., & Baumgartner, W.A. (2003). Cognitive changes with coronary artery disease: A prospective study of coronary artery bypass graft patients and nonsurgical controls. Annals of Thoracic Surgery, 75, 1377–1384.CrossRefGoogle ScholarPubMed
Selnes, O.A., & Zeger, S.L. (2007). Coronary artery bypass grafting baseline cognitive assessment: Essential not optional. Annals of Thoracic Surgery, 83, 374–376.CrossRefGoogle Scholar
Shaw, P.J., Bates, D., Cartlidge, N.E., French, J.M., Heaviside, D., Julian, D.G. et al. (1987). Long-term intellectual dysfunction following coronary artery bypass graft surgery: A six month follow-up study. Quarterly Journal of Medicine, 62, 259–268.Google ScholarPubMed
Silbert, B.S., Evered, L.A., Scott, D.A., & Cowie, T.F. (2008). The apolipoprotein E epsilon4 allele is not associated with cognitive dysfunction in cardiac surgery. Annals of Thoracic Surgery, 86, 841–847.CrossRefGoogle Scholar
Sugiyama, N., Kawaguchi, M., Yoshitani, K., Sugiyama, M., Inoue, S., Sakamoto, T. et al. (2002). The incidence and severity of cognitive decline after major noncardiac surgery: A comparison with that after cardiac surgery with cardiopulmonary bypass. Journal of Anesthesiology, 16, 261–264.Google ScholarPubMed
Symes, E., Maruff, P., Ajani, A., & Currie, J. (2000). Issues associated with the identification of cognitive change following coronary artery bypass grafting. Australian and New Zealand Journal of Psychiatry, 34, 770–784.CrossRefGoogle ScholarPubMed
Takagi, H., Tanabashi, T., Kawai, N., & Umemoto, T. (2007). A meta-analysis of minimally invasive coronary artery bypass versus percutaneous coronary intervention with stenting for isolated left anterior descending artery disease is indispensable. Journal of Thoracic and Cardiovascular Surgery, 134, 548–549.CrossRefGoogle ScholarPubMed
van Dijk, D., Keizer, A.M., Diephuis, J.C., Durand, C., Vos, L.J., & Hijman, R. (2000). Neurocognitive dysfunction after coronary artery bypass surgery: A systematic review. Journal of Thoracic and Cardiovascular Surgery, 120, 632–639.CrossRefGoogle ScholarPubMed
van Dijk, D., Spoor, M., Hijman, R., Nathoe, H.M., Borst, C., Jansen, E.W. et al. (2007). Cognitive and cardiac outcomes 5 years after off-pump vs. on-pump coronary artery bypass graft surgery. Journal of the American Medical Association, 297, 701–708.CrossRefGoogle ScholarPubMed
Westaby, S., Saatvedt, K., White, S., Katsumata, T., van Oeveren, W., & Halligan, P.W. (2001). Is there a relationship between cognitive dysfunction and systemic inflammatory response after cardiopulmonary bypass? Annals of Thoracic Surgery, 71, 667–672.CrossRefGoogle Scholar