NEUROPSYCHOLOGICAL CHANGES AFTER OPEN HEART SURGERY
Changes in neurological and psychiatric functioning have been noted following open heart surgery. Most studies have involved valve surgery patients and little is proven if such changes occur following coronary artery bypass graft surgery (CABG). The present study was undertaken to quantify and qualify changes in neuropsychological functioning following such surgery. Two groups of cardiac patients, 27 coronary artery bypass graft patients and 24 medically managed non-surgical cardiac patients were evaluated using an extensive neuropsychological test battery. Surgical patients were evaluated pre-surgically, ten days post-surgically, and six months post-surgically. The medically managed non-surgical patients were evaluated using a similar time frame. Group comparisons on non-experimental descriptive measures showed no age differences in IQ, socioeconomic level, and duration of illness. Notable baseline group differences were noted on various neuropsychological measures. The CABG group was inferior to the medically managed non-surgical group. Analysis of post-surgical results showed the CABG group to decline significantly on visual spatial construction skills and non-verbal memory. The medically managed group's performance was essentially unchanged. Analysis of six month follow-up results showed marked recovery of function for the CABG group. In certain measures, the CABG group's performance surpassed their baseline level of functioning. Analysis of the medically managed group's performance across the three test periods showed no significant trends for certain measures and a significant improvement effect for certain measures which was probably a learning effect. The post-surgical changes on functioning seen in the present study are consistent with those seen in previous studies of valve surgery patients. The baseline differences in neuropsychological functioning indicate the necessity for considering surgical exacerbation of presurgical compromises in neuropsychological functioning. Several possible causes for the noted changes are discussed. No single factor can be named and a combination of causes such as hypotension, hypothermia and microembolization may be the likely cause for the deficits.
SY, MICHAEL JOHN, "NEUROPSYCHOLOGICAL CHANGES AFTER OPEN HEART SURGERY" (1981). ETD Collection for Fordham University. AAI8123470.