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Causes of Mental Decline After Open Heart Surgery

written by: Dr. Kristie Leong • edited by: Diana Cooper • updated: 11/27/2010

Does mental decline after open heart surgery occur? If so, what causes this phenomenon? Find out how heart surgery affects brain function.

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    Open heart surgery is stressful for both a patient and their family, so it’s not surprising that patients undergoing this procedure experience some anxiety. Some doctors even believe that patients experience mental decline after open heart surgery. Is there any truth to this idea?

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    Mental Decline and Open Heart Surgery

    When surgeons first began doing open heart surgery, some of them observed that patients experienced mood changes and subtle alterations in cognitive function after the procedure. They believed this could be due to the stress surgery places on the body and the fact that blood flow may be briefly interrupted to the brain during the procedure, although this idea was never thoroughly researched.

    Several years ago, the concept of mental decline after having open heart surgery was put to the test. Researchers compared two groups of patients. One group underwent a CABG procedure, a form of open heart surgery to open up blocked arteries, and the other group underwent PCI (percutaneous coronary intervention), a procedure that involves opening a heart artery blockage without open heart surgery. Prior to the procedures, they underwent cognitive testing. After completion of the procedures, researchers tested the cognitive function of both groups at three weeks, four months and a year. A control group also underwent the same cognitive assessments for comparison purposes.

    The results? There was no significant difference in cognitive processing speed or the ability to learn or retain new information between the groups who had open heart surgery, PCI or the healthy control group at one year.

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    Another Study Looking at Cognitive Decline and Open Heart Surgery

    Another study carried out at Johns Hopkins School of Medicine compared open heart surgery (CABG) to PTCA, a less invasive procedure for treating heart blockages. Both groups of patients had mild cognitive changes when followed up at twelve months and three years after the procedures. Researchers believe these mild cognitive changes were likely related to progression of their heart disease rather than a direct result of open heart surgery, especially since they saw changes in both groups. Interestingly, they did see a slight reduction in cognitive function in the patients who underwent open heart surgery immediately after the surgery that weren’t seen in the PTCA group, but these mental and cognitive changes resolved within three months.

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    The Bottom Line

    Changes in cognitive function and mental decline after open heart surgery may occur transiently after the procedure, but, in most cases, they resolve within a few months in the absence of complications. On the other hand, patients who undergo open heart surgery or less invasive procedures to treat heart disease may have some cognitive changes due to progression of their heart disease. Overall, patients considering open heart surgery shouldn’t be fearful of experiencing mental decline as a result of the surgery.

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    References

    Medscape.com. "CABG Surgery Does Not Increase Risk of Long-term Cognitive Decline"

    Medical News Today. “Does Open Heart Surgery Cause Cognitive Decline? Rigorous Study says “No”.