• M J Andrew, R A Baker, J Bennetts, A C Kneebone, and J L Knight.
• Department of Surgery, Flinders Medical Centre and Flinders University of South Australia, Adelaide.
• J. Cardiothorac. Vasc. Anesth. 2001 Feb 1; 15 (1): 9-14.

ObjectiveTo compare the incidence of neuropsychologic deficits 1 week and 6 months after coronary artery bypass graft (CABG) surgery (extracardiac) and valve surgery with or without CABG surgery (intracardiac) using reliable change indices to define the incidence of neuropsychologic deficits.DesignProspective study.SettingCardiac surgical unit in a university teaching hospital.ParticipantsPatients scheduled for elective multiple-graft (> or =3 grafts) CABG surgery (n = 59), or elective valve surgery (with or without concomitant CABG surgery) (n = 50) and a matched sample of nonsurgical controls (n = 53).InterventionsNeuropsychologic assessments were performed 1 day before surgery, 7 days and 6 months after surgery.Measurements And Main ResultsThe 7-day assessment showed no significant differences between valve surgery patients and CABG surgery patients in the incidence of neuropsychologic deficits. When reassessed 6 months postoperatively, the valve group displayed a significantly higher incidence of deficits on the digit symbol test compared with the CABG group (valve 26.7% v CABG 6.8%). In the CABG group, there was a significant change in the incidence of deficits per patient from 7 days to 6 months (p = 0.03) that was not evident in the valve group.ConclusionThere are some differences in the neuropsychologic outcome of extracardiac and intracardiac surgery. Patients undergoing isolated CABG surgery showed a greater reduction in the incidence of persisting deficits at 6 months than patients undergoing valve surgery with or without CABG surgery. This finding warrants further investigation, with particular attention to patients undergoing combined valve and coronary artery procedures.

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