Neuropsychological changes following coronary artery bypass surgery

Abstract

The various studies conducted till date reveal that up to 40% patients undergoing coronary artery bypass surgery are associated with minor or persistent neuropsychological disorders. A significant concern has been emphasized on short and long term morbidity in cases of CABG procedure. The outcome in the form of morbidity after this surgery, irrespective of co-existing medical diseases, is prevalent in presence of neuropsychological problems, such as anxiety, depression and cognitive impairments, though the exact mechanism of this behavioural aspect is obscure. As such, there may not be serious psychological dysfunction but chances of incident delirium at the time of admission are quite high. These neuropsychological deficits may continue over time, especially if the features persisted in preoperative period, too. To improve the detection of these psychological disorders in CABG surgery cases, the clinicians must consider the use of specified screening methods. Perioperative factors, as well as patient-related risk factors, play a vital role in development of cognitive dysfunctions. Recent literature emphasizes the possibility of a grave complication in the form of ischaemic stroke in post- CABG surgical patients. The microemboli may enter cerebral circulation during surgery leading to cognitive decline, postoperatively. In the recent literature, that include various studies covering the neuropsychological areas, conflicts and limitations in methodology are prevalent.