Effect of Open-Heart Surgery on Intellectual Function

Åberg, Torkel; Kihlgren, Margareta

doi:10.3109/14017437609167797

Cited by 36 publications

(36 citation statements)

References 5 publications

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“…Aberg and Kihlgren in 1974 studied the neuropsychological outcome in 113 patients undergoing surgery with ECC and a control group of 46 patients operated upon for general thoracic surgical conditions. 17 Patients both with and without clinically evident cerebral complications in the ECC group showed significant deterioration in mean neuropsychological scores at 1 week after operation. The control group showed improvement in the mean scores for 4 subtests and a nonsignificant decrease for 2.…”

Section: Discussionmentioning

confidence: 89%

Neurologic and neuropsychological morbidity following major surgery: comparison of coronary artery bypass and peripheral vascular surgery.

Shaw¹,

Bates²,

Cartlidge³

et al. 1987

Stroke

427

120

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As part of a prospective study of the neurologic and neuropsychological complications of coronary artery bypass graft surgery, 312 patients were compared with a control group of 50 patients undergoing major surgery for peripheral vascular disease. The purpose of comparing the 2 groups was to determine to what extent neurologic complications after heart surgery can be attributed to cardiopulmonary bypass. The 2 groups were similar with respect to age, preoperative neurologic and intellectual status, anesthetic methods, duration of operation, perioperative complications, and time spent in the intensive therapy unit. Certain potential risk factors for cerebrovascular disease were more common in the control than the coronary bypass patients. The important difference between the 2 groups was that only the latter group underwent cardiopulmonary bypass. In this group 191 of 312 (61%) and 235 of 298 (79%), respectively, developed early neurologic and neuropsychological complications. By the time of hospital discharge 17% had neurologic disability and 38% had significant neuropsychological symptoms. In the control group 9 of 50 (18%) developed neurologic complications resulting largely from trauma to lower limb sensory nerves. Two patients developed primitive reflexes. Fifteen of 48 (31%) showed neuropsychological impairment on 1 or 2 subtest scores. Moderate or severe intellectual dysfunction was not seen in the control patients in contrast to the 24% thus affected in the coronary bypass group. The difference in frequency and severity of central nervous system complications between the 2 groups is likely to reflect cerebral injury resulting from cardiopulmonary bypass. (Stroke 1987;18:700-707)

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Section: Discussionmentioning

confidence: 89%

Neurologic and neuropsychological morbidity following major surgery: comparison of coronary artery bypass and peripheral vascular surgery.

Shaw¹,

Bates²,

Cartlidge³

et al. 1987

Stroke

427

120

View full text Add to dashboard Cite

show abstract

“…During the course of a week, clinical evidence of brain dysfunction resolved completely, or nearly so. Those who have recorded cerebral damage in patients after CPB have likewise reported that the condition in most cases is self-correcting (Tufo et al, 1970;Aberg, 1974).…”

Section: Resultsmentioning

confidence: 99%

“…Although cerebral damage after heart surgery can be permanent, the evidence is that it is often transient (Tufo et al, 1970;Aberg, 1974;Branthwaite, 1975). We wondered if the clinical evidence of transient cerebral dysfunction might be associated with a transient morphological 736 alteration in the brain microvasculature.…”

mentioning

confidence: 99%

Transitory cerebral microvascular blockade after cardiopulmonary bypass.

Patterson¹,

Rosenfeld²,

Porro³

1976

Thorax

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. (1976). Thorax, 31,[736][737][738][739][740][741]. Transitory cerebral microvascular blockade after cardiopulmonary bypass. Dogs were submitted to cardiopulmonary bypass (CPB) carried out under conditions calculated to generate large numbers of microbubbles and microemboli. On the day following the procedure the dogs showed evidence of neurological damage including impaired consciousness and ataxia. These abnormalities largely cleared within a week. When the animals were sacrificed at intervals after the procedure, the cerebral microvasculature was demonstrated by injecting a suspension of lamp black into the carotid artery. This revealed that multiple filling defects were present in the microcirculation of the brain immediately after CPB and f6r two days thereafter. However, by seven days the microvascular blockade had disappeared, and the vascular pattern of the brain had returned to normal. Neuropathological findings were sparse and restricted to the cerebellum.This study suggests that the transient neurological syndromes that sometimes follow cardiopulmonary bypass for heart surgery may be due to a transient microvascular blockade, perhaps by microbubbles and microparticles.

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“…On the basis of their performance on a battery of six tests administered preoperatively, 8 days after surgery, and again 8 weeks after surgery, Aberg and Khilgren concluded that arterial line filters confer a degree of protection against cerebral injury during CPB. 8 On theoretical grounds arterial line filters might prevent cerebral damage by removing microemboli from the circulation. In dogs a rise in cerebrospinal fluid brain creatine phosphokinase can be demonstrated during CPB.…”

mentioning

confidence: 99%

The impact of microemboli during cardiopulmonary bypass on neuropsychological functioning.

Pugsley

Klinger

Paschalis

et al. 1994

Stroke

652

360

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Results Significantly more patients were found to have neuropsychological deficits in the group without the arterial line filter at both 8 days (P<.05) and 8 weeks (P<.03) after surgery. In addition, more "soft" neurological signs were found in the nonfiltered group 24 hours after surgery (P<.05). More high-intensity transcranial signals were found in the nonfiltered group, and the number of high-intensity transcranial signals was found to be related to the likelihood of a patient having a neuropsychological deficit at 8 weeks.Conclusions These data suggest that neuropsychological deficits after routine cardiopulmonary bypass are related to the number of microemboli delivered during surgery. Furthermore, the numbers of microemboli may be reduced by including a 40-^m filter on the arterial line. (Stroke. 1994;25:1393-1399

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Effect of Open-Heart Surgery on Intellectual Function

Abstract: Scund J Thor Crirdror,rr\~ Sulk' lo Scand Cardiovasc J Downloaded from informahealthcare.com by University of Otago on 01/03/15 For personal use only.

Cited by 36 publications

References 5 publications

Neurologic and neuropsychological morbidity following major surgery: comparison of coronary artery bypass and peripheral vascular surgery.

Neurologic and neuropsychological morbidity following major surgery: comparison of coronary artery bypass and peripheral vascular surgery.

Transitory cerebral microvascular blockade after cardiopulmonary bypass.

The impact of microemboli during cardiopulmonary bypass on neuropsychological functioning.

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