'Head and heart'--neurological and psychological reactions to open heart surgery

Neurological and psychological reactions to open-heart surgery are widely underestimated phenomena and occur in a much higher incidence than one might expect. When analyzed retrospectively, up to 3.8% of patients who underwent cardiac surgery at the Hamburg University Hospital exhibited these reactions, whereas 35%-50% presented with symptoms and signs of perioperative CNS dysfunctions in prospective studies at our department. About the same percentages are detected in prospective studies of the patients' perioperative psychopathology, stating that a great number of cardiac patients exceed the normal range of anxious, tense, and depressive moods in this setting. The consequences of these findings for the patients' quality of life and the impact for the perioperative management of patients undergoing open-heart surgery are discussed. The current prospective studies, preliminary results of which are presented here, are part of an international interdisciplinary study, initiated to bring more light into the complicated relations between ECC-assisted cardiac surgery, anaesthesiology, neurology and psychology.