| Does Bypass Surgery Lead to Cognitive Decline?
Does Bypass Surgery Lead to Cognitive Decline?
Posted by Simeon Margolis, M.D., Ph.D.
on Sun, Mar 19, 2006, 6:02 pm PST Post a Comment
Are you worried that having bypass surgery may slow your thinking? A decline in cognitive function after coronary artery bypass surgery has generally been attributed to the use of the cardiopulmonary pump. In this type of surgery, the heart is stopped and the functions of the heart and lungs are replaced by a cardiopulmonary pump, which removes carbon dioxide from the blood, adds oxygen to the blood, and then pumps it to organs throughout the body.
Now, several studies by neurologists at Johns Hopkins have raised doubts about this assumption. They measured cognitive function in patients before and several times after bypass surgery. The results were compared with control groups who had coronary heart disease but did not undergo surgery. The researchers found that after 1 and 3 years performance in tests of cognitive function were similar in both groups. They concluded that short-term, temporary changes can result from the use of a cardiopulmonary pump, but any long-term fall in cognitive function after bypass surgery is not due to the use of a cardiopulmonary pump. Rather they believe bypass patients may have long-term declines in cognitive function because they, and other people with coronary artery disease, are more likely to have narrowed arteries supplying blood to the brain.
Their studies also found that long-term cognitive decline was no different whether patients underwent coronary bypass with a cardiopulmonary pump or had off-pump surgery, in which the heart continues to beat during the operation. One reason off-pump surgery was developed was to prevent the cognitive decline many believed resulted from use of a cardiopulmonary pump.
In the hands of an experienced surgeon off-pump surgery is a safe and effective alternative to conventional bypass surgery. If bypass surgery is recommended, you should learn what type of procedure your surgeon plans to use and be sure he or she has plenty of experience with the chosen procedure.
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