Original ArticlesEarly neurobehavioral disorders after cardiac surgery: A comparative analysis of coronary artery bypass graft surgery and valve replacement*,**
Section snippets
Methods
From a consecutive series of 235 patients undergoing elective cardiac surgery at the Department of Heart and Vascular Surgery at Freiburg University or at the Department of Thoracic and Cardiovascular Surgery at Magdeburg University, the preoperative and postoperative neuropsychologic performance of 42 patients undergoing valve replacement were compared with 42 patients undergoing CABG surgery matched by sex, age, and preoperative cognitive status (using the Mini Mental State Examination [MMSE]
Results
Median number of bypass grafts in patients undergoing elective CABG surgery was 3 (range, 2-6). Eighteen patients received an aortic valve replacement; 8 patients, a mitral valve replacement; and 4 patients a combined surgery. In 12 patients, valve replacement was combined with CABG surgery. Table 1 shows the demographic and clinical variables of the patient groups.Empty Cell Empty Cell CABG VR p* No. Empty Cell 42 42 Empty Cell Sex (female/male) Empty Cell 17/25 17/25 ns Age (y)† 63.5 63.1 40-80 63.5 63.6 37-82 ns Preoperative MMSE†
Discussion
The present data show that patients undergoing valve replacement exhibit more severe neuropsychologic disorders and a significantly prolonged recovery during the postacute stage after surgery. The difference between valve replacement and CABG surgery patients was most marked in learning and memory performance and in a calculation task. Because both samples were matched for sex, age, and preoperative cognitive state, these differences cannot be attributed to the respective sample characteristics.
Acknowledgements
The authors thank V. Schlosser, MD, former Director of the Department of Cardiac and Vascular Surgery, Freiburg University, for allowing access to patients under his care; C.W. Wallesch, MD, Magdeburg University, for helpful comments during study design; and Inka Eisfeld, for support during revision of the manuscript.
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Cited by (0)
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Supported in part by the Federal Ministry of Education and Research, the State of Saxony-Anhalt, and the State of Baden-Württemberg/Research Program on Neuropsychology and Neurolinguistics.
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Address reprint requests to Manfred Herrmann, MD, PhD, Division of Neuropsychology and Behavioral Neurology, Otto-von-Guericke University, Leipziger Strasse 44, D-39120 Magdeburg, Germany.