HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Martin Czerny Ernst Wolner Michael Grimm Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Zimpfer, D. Articles by Grimm, M. Search for Related Content PubMed PubMed Citation Articles by Zimpfer, D. Articles by Grimm, M. Related Collections Cerebral protection

Ann Thorac Surg 2004;78:513-518
© 2004 The Society of Thoracic Surgeons

---

Original article: cardiovascular

Neurocognitive deficit following coronary artery bypass grafting: a prospective study of surgical patients and nonsurgical controls

^a Department of Cardiothoracic Surgery, University of Vienna, Vienna, Austria
^b Department of Internal Medicine, University of Vienna, Vienna, Austria
^c Department of Cardiac Surgery, University of Innsbruck, Innsbruck, Austria

Accepted for publication December 29, 2003.

^* Address reprint requests to Dr Grimm, Department of Cardiothoracic Surgery, University of Vienna, Wahringer Guertel 18-20, A-1090 Vienna, Austria
e-mail: michael.grimm{at}akh-wien.ac.at

BACKGROUND: To objectively measure long-term neurocognitive deficit in patients undergoing coronary artery bypass grafting and compare the findings with nonsurgical controls.

METHODS: We prospectively measured neurocognitive function in patients undergoing coronary artery bypass grafting (CABG) with cardiopulmonary bypass (n = 104; mean age 64.1 years old; EuroSCORE 2.7 [means]). A cohort of age- and sex-matched patients (n = 80; mean age 63.4 years old) served as nonsurgical controls. After CABG, neurocognitive function was serially reevaluated at 7-day (n = 104), 4-month (n = 100), and 3-year follow-up (n = 88). Neurocognitive function was objectively measured by means of cognitive P300 evoked potentials. Additionally, standard psychometric tests were performed (Trailmaking Test A, Mini Mental State Examination).

RESULTS: As compared to preoperative measures (364 ± 36 ms), cognitive P300 evoked potentials were prolonged (=impaired) at 7-day (381 ± 36 ms; p = 0.001), 4-month (378 ± 31 ms; p = 0.08), and 3-year follow-up (379 ± 35 ms; p = 0.002), respectively. Trailmaking Test A was abnormal, as compared to preoperative, at 3-year follow-up (p < 0.001). Before the operation, surgical patients were fully comparable in P300 measures to nonsurgical controls (363 ± 32 ms; p = 0.362). Most importantly, throughout the entire postoperative follow-up cognitive measures in surgical patients were prolonged (=impaired) as compared with controls (7-day p = 0.001; 4-month p = 0.002 and 3-year p = 0.003, respectively). In stepwise multivariate regression analysis, neurocognitive deficit at 4-month follow-up (p < 0.001), age (p = 0.012), and persistent atrial fibrillation (p = 0.024) were predictive for long-term neurocognitive deficit at 3-year follow-up.

CONCLUSIONS: As shown by means of objective measures, and in comparison to nonsurgical controls, coronary artery bypass grafting with cardiopulmonary bypass grafting causes long-term neurocognitive deficit.

This article has been cited by other articles:

				J. P. Slater, T. Guarino, J. Stack, K. Vinod, R. T. Bustami, J. M. Brown III, A. L. Rodriguez, C. J. Magovern, T. Zaubler, K. Freundlich, et al. Cerebral Oxygen Desaturation Predicts Cognitive Decline and Longer Hospital Stay After Cardiac Surgery Ann. Thorac. Surg., January 1, 2009; 87(1): 36 - 45. [Abstract] [Full Text] [PDF]

				J. J. Sweet, E. Finnin, P. L. Wolfe, J. L. Beaumont, E. Hahn, J. Marymont, T. Sanborn, and T. K. Rosengart Absence of Cognitive Decline One Year After Coronary Bypass Surgery: Comparison to Nonsurgical and Healthy Controls Ann. Thorac. Surg., May 1, 2008; 85(5): 1571 - 1578. [Abstract] [Full Text] [PDF]

				S. C. Knipp, N. Matatko, H. Wilhelm, M. Schlamann, M. Thielmann, C. Losch, H. C. Diener, and H. Jakob Cognitive Outcomes Three Years After Coronary Artery Bypass Surgery: Relation to Diffusion-Weighted Magnetic Resonance Imaging Ann. Thorac. Surg., March 1, 2008; 85(3): 872 - 879. [Abstract] [Full Text] [PDF]

				S. J. Durham and J. P. Gold Late Complications of Cardiac Surgery Card. Surg. Adult, January 1, 2008; 3(2008): 535 - 548. [Full Text]

				T. K. Rosengart, J. J. Sweet, E. Finnin, P. Wolfe, J. Cashy, E. Hahn, J. Marymont, and T. Sanborn Stable Cognition After Coronary Artery Bypass Grafting: Comparisons With Percutaneous Intervention and Normal Controls Ann. Thorac. Surg., August 1, 2006; 82(2): 597 - 607. [Abstract] [Full Text] [PDF]

				M. Weigl, A. Moritz, B. Steinlechner, I. Schmatzer, B. Mora, R. Fakin, D. Zimpfer, H. J. Ankersmit, C. Khazen, and M. Dworschak Neuronal injury after repeated brief cardiac arrests during internal cardioverter defibrillator implantation is associated with deterioration of cognitive function. Anesth. Analg., August 1, 2006; 103(2): 403 - 9, table of contents. [Abstract] [Full Text] [PDF]

				C. S. Ernest, M. U.C. Worcester, J. Tatoulis, P. C. Elliott, B. M. Murphy, R. O. Higgins, M. R. Le Grande, and A. J. Goble Neurocognitive Outcomes in Off-Pump Versus On-Pump Bypass Surgery: A Randomized Controlled Trial Ann. Thorac. Surg., June 1, 2006; 81(6): 2105 - 2114. [Abstract] [Full Text] [PDF]

				T. K. Rosengart, J. Sweet, E. B. Finnin, P. Wolfe, J. Cashy, E. Hahn, J. Marymont, and T. Sanborn Neurocognitive Functioning in Patients Undergoing Coronary Artery Bypass Graft Surgery or Percutaneous Coronary Intervention: Evidence of Impairment Before Intervention Compared With Normal Controls Ann. Thorac. Surg., October 1, 2005; 80(4): 1327 - 1335. [Abstract] [Full Text] [PDF]