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Ann Thorac Surg 1999;68:1464
© 1999 The Society of Thoracic Surgeons

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Supplement: Outcomes ’99: Scientific Abstracts

Incidence of neuropsychological deficit following valve surgery

^a Cardiac Surgical Research Group and Health Psychology, Flinders Medical Centre, Adelaide, South Australia, Australia

Background: Recent evidence has challenged the belief that valve surgery inflicts greater neuropsychological (NP) morbidity than coronary artery bypass. The aim of this study was to determine the incidence of NP decline following valve and coronary artery bypass graft (CABG) surgery using Reliable Change Indices (RCI) [1].

Methods: Following informed consent, NP examinations were performed the day before, 7 days, and 6 months after surgery in 50 valve patients, and 59 CABG patients ( 3 grafts). A matched group of 53 unpaid volunteers were similarly examined to establish the RCI control for test reliability and practice effects.

Results: The three groups were well watched on population demographics and preoperative NP data. The number of patients demonstrating decline in one or more tests at 7 days and 6 months in each group was 38 of 50 (valve), 45 of 59 (CABG), and 21 of 30 (valve), 20 of 34 (CABG), respectively. Valve patients completing the 6 month NP assessment demonstrated no significant reduction in the incidence of decline (80% 7 day vs 70% 6 month), while in the graft patients there was a significant reduction from 79% to 59% (p < 0.05). The NP measures most susceptible to postoperative decline at 7 days were Digit Symbol (valve 46%, CABG 34%), Trail Making Test B (38%, 34%) and CVLT Discriminability (18%, 14%), whilst at 6 months Trail Making Test A (33%, 24%), Trail Making Test B (20%, 18%), and Digit Symbol (27%, 9%) were most susceptible.

Conclusions: Our data supports the belief that there may be some differences in NP outcome between valve surgery and multiple graft surgery patients.

References

1. Ann Thorac Surg 1998;65:1320–5.

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Baker, R.A. Articles by Knight, J.L. Search for Related Content PubMed Articles by Baker, R.A. Articles by Knight, J.L.