• A D Ebert, T A Walzer, C Huth, and M Herrmann.
• Department of Thoracic and Cardiovascular Surgery, Otto-von-Guericke-University, Magdeburg, Germany.
• J. Cardiothorac. Vasc. Anesth. 2001 Feb 1; 15 (1): 15-9.

ObjectiveTo analyze neurobehavioral disorders in the early postoperative period after valve replacement and coronary artery bypass graft (CABG) surgery.DesignProspective study.SettingUniversity hospital.ParticipantsPatients undergoing elective cardiac surgery with cardiopulmonary bypass; 42 patients in the valve replacement surgery group and 42 patients in the CABG surgery group, with both groups matched post hoc for age, sex, and preoperative cognitive status.Measurements And Main ResultsAll subjects were investigated preoperatively as well as 2 and 7 days postoperatively with a comprehensive neuropsychologic and neuropsychiatric assessment. The groups did not significantly differ with respect to the incidence of postoperative neuropsychiatric disorders. Valve replacement surgery patients exhibited more severe neuropsychologic deficits and showed a slower recovery than patients who underwent CABG surgery. In both groups, postoperative neuropsychologic alterations were most marked in fluency, arithmetic, and memory performance.ConclusionThese results indicate that patients after valve replacement surgery have a higher risk of postoperative neuropsychologic alterations mainly attributable to temporal lobe dysfunction. This finding corresponds to a specific vulnerability of hippocampal structures to transient hypoxia.

20 keywords...

hide…