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Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
09:12

Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery

Published on: March 27, 2018

Cognitive outcomes in elderly high-risk patients 1 year after off-pump versus on-pump coronary artery bypass

Birte Østergaard Jensen1, Lars S Rasmussen, Daniel A Steinbrüchel

  • 1Department of Cardio-Thoracic Surgery, The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. bjen0094@bbh.regionh.dk

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|September 10, 2008
PubMed

Insights

Off-pump coronary artery bypass grafting (CABG) did not significantly reduce postoperative cognitive dysfunction (POCD) in elderly, high-risk patients compared to on-pump surgery. Cognitive outcomes were similar one year after either procedure.

Area of Science:

  • Cardiology
  • Neurology
  • Geriatric Medicine

Background:

  • Postoperative cognitive dysfunction (POCD) is a concern after cardiac surgery, particularly in elderly patients.
  • Age is the primary risk factor for POCD.
  • Coronary artery bypass grafting (CABG) without cardiopulmonary bypass (off-pump) is hypothesized to reduce neurological complications.

Purpose of the Study:

  • To compare the incidence of POCD between off-pump and on-pump CABG in elderly, high-risk patients.
  • To evaluate cognitive outcomes one year after cardiac surgery.

Main Methods:

  • A sub-study of a randomized trial comparing off-pump vs. on-pump CABG.
  • 120 elderly patients (mean age 76) underwent pre-operative cognitive testing.
  • 90 patients were retested at one year using a neuropsychological battery; POCD defined as ≥2/7 deficits.

Main Results:

  • The incidence of POCD was 19% in the off-pump group and 9% in the on-pump group (p=0.18).
  • No significant differences in cognitive decline were observed between groups, regardless of the definition used.

Conclusions:

  • Off-pump CABG was not associated with significantly better cognitive outcomes than on-pump CABG in elderly, high-risk patients at one year.
  • Further research may be needed to fully elucidate the neurological impact of different CABG techniques.
Abstract

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