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Presurgical cognitive deficits in patients receiving coronary artery bypass graft surgery

Published online by Cambridge University Press:  27 August 2003

Katherine P. Rankin ,
Gary S. Kochamba ,
Kyle B. Boone ,
Diana B. Petitti  and
J. Galen Buckwalter
Katherine P. Rankin*
Affiliation:
University of California at San Francisco Memory and Aging Center, San Francisco, California
Gary S. Kochamba
Affiliation:
Southern California Kaiser Permanente Medical Group, Pasadena, California
Kyle B. Boone
Affiliation:
Harbor UCLA Medical Center, Torrance, California
Diana B. Petitti
Affiliation:
Southern California Kaiser Permanente Medical Group, Pasadena, California
J. Galen Buckwalter
Affiliation:
Southern California Kaiser Permanente Medical Group, Pasadena, California
*
Reprint requests to: Katherine P. Rankin, Ph.D., UCSF Memory and Aging Center, 350 Parnassus Avenue, Suite 706, San Francisco, CA 94143-1207. E-mail: [email protected]
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Abstract

Coronary artery bypass graft (CABG) surgery with cardiopulmonary bypass (CPB) can produce a higher incidence of neuropsychological complications than other types of highly invasive noncardiac vascular surgery. Cognitive complications most likely arise from either embolization or hypoxia. An alternative surgical procedure has been developed that allows CABG to be performed without stopping the heart (“off-pump” CABG, or OPCABG). This study examined the neuropsychological performance of patients undergoing OPCABG, hypothesizing that patients undergoing OPCABG would show fewer cognitive deficits than patients whose hearts were stopped. A 1-hr neuropsychological battery was administered preoperatively to 43 patients before prospective randomization to either CPB CABG or OPCABG, and again to 34 of those patients 2 to 3 months postoperatively by an examiner blind to surgical condition. Neuropsychological status did not change 2.5 months postsurgically in either OPCABG or CABG groups. However, both groups showed dramatic presurgical cognitive deficits in multiple domains, particularly verbal memory and psychomotor speed. This corroborates previous research suggesting that patients requiring CABG surgery may evidence significant presurgical cognitive deficits as a result of existing vascular disease. (JINS, 2003, 9, 913–924.)

Keywords

OPCABGNeuropsychological scoresCoronary artery bypassCardiovascular diseases
Type
Research Article
Information
Journal of the International Neuropsychological Society , Volume 9 , Issue 6 , September 2003 , pp. 913 - 924
Copyright
Copyright © The International Neuropsychological Society 2003

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