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[Changes in Cerebral Blood Flow and Cognitive Function in Patients Undergoing Coronary Bypass Surgery With
Insights
Coronary artery bypass graft (CABG) surgery using cardiopulmonary bypass (CPB) can reduce cerebral blood flow and impair cognitive functions like memory and psychomotor speed in patients with ischemic heart disease (IHD).
Area of Science:
- Neuroscience
- Cardiovascular Surgery
- Medical Imaging
Context:
- Ischemic heart disease (IHD) affects millions globally, often necessitating surgical intervention.
- Coronary artery bypass graft (CABG) surgery with cardiopulmonary bypass (CPB) is a common treatment for IHD.
- The impact of CPB on cerebral perfusion and cognitive function remains a critical area of investigation.
Purpose:
- To investigate the effects of CABG surgery with CPB on regional cerebral blood flow (rCBF).
- To assess the impact of CABG with CPB on cognitive functions in patients with IHD.
- To correlate changes in cerebral perfusion with cognitive status post-surgery.
Summary:
- Twenty-two IHD patients undergoing CABG with CPB were evaluated using brain SPECT and neuropsychological tests before and after surgery.
- A significant reduction in rCBF was observed in the frontal and parietal cortex post-CABG with CPB.
- Cognitive deficits, including decreased verbal memory, learning, and psychomotor speed, were noted, correlating with reduced cerebral perfusion.
Impact:
- CABG with CPB is associated with reduced cerebral perfusion, potentially leading to cognitive dysfunction.
- Verbal memory, learning, and psychomotor speed are particularly sensitive to the neurological effects of this surgical procedure.
- Findings highlight the need for monitoring and potential interventions to mitigate cognitive decline in patients undergoing CABG with CPB.
Purpose:
to study effect of coronary artery bypass graft (CABG) surgery with cardiopulmonary bypass (CPB) on regional cerebral blood flow and cognitive function in patients with ischemic heart disease (IHD).
Material And Methods:
We included into this study 22 patients with IHD subjected to CABG surgery with CPB. All patients underwent brain SPECT scanning and comprehensive neuropsychological testing 1 day before, 10-14 days and 6 months after surgery.
Results:
Overall CABG with CPB was followed by reduction of regional cerebral blood flow relative to baseline in frontal and parietal cortex (p < 0.01). Substantial reduction (> 5%) of cerebral perfusion in early postoperative period was observed in 15 patients (68%) while seven patients (32%) had no significant changes of regional cerebral blood flow. Changes of cerebral perfusion correlated with dynamics of cognitive status. Mean measures of immediate verbal memory, delayed memory, and learning decreased after surgery by 25.6 (p = 0.002), 43.3 (p = 0.000003), and 23.1% (p = 0.00000), respectively. Moreover after CABG with CPB patients demonstrated slowing of psychomotor speed by 13.6% (p = 0.03).
Conclusion:
CABG with CPB was associated with reduction of cerebral perfusion leading to cognitive dysfunction. Immediate and delayed verbal and visual memory, learning and psychomotor speed were most sensitive to the negative effects of surgery.
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