Short-term outcome of attention and executive functions from aorta no-touch and traditional off-pump coronary artery bypass surgery

• Published in: The world journal of biological psychiatry Vol. 15; no. 5; pp. 397 - 403
• Main Authors: Szwed, Krzysztof, Pawliszak, Wojciech, Anisimowicz, Lech, Buci ski, Adam, Borkowska, Alina
• Format: Journal Article
• Language: English
• Published: England Informa Healthcare 01.07.2014; Taylor & Francis
• Subjects: Aged; Attention - physiology; brain injuries; cardiac surgical procedures; Cognition Disorders - etiology; complications; Coronary Artery Bypass, Off-Pump - adverse effects; Coronary Artery Bypass, Off-Pump - methods; Coronary artery disease; Executive Function - physiology; Female; Humans; Male; Middle Aged; neuropsychology; Postoperative Complications - etiology; Prospective Studies; Treatment Outcome; neuropsychology; complications; brain injuries; Coronary artery disease; cardiac surgical procedures
• ISSN: 1562-2975; 1814-1412; 1814-1412
• DOI: 10.3109/15622975.2013.824611

Abstract Objectives. Postoperative cognitive dysfunction (POCD) is an important neuropsychiatric complication of coronary artery bypass grafting (CABG). It is most likely caused by microembolic brain damage and affects domains of attention, memory, executive functions and dexterity. In order to achieve better neuroprotection, surgeons introduced some advantageous operating procedures. Noteworthy among them is a state-of-the-art off-pump CABG aorta no-touch technique ("no touch" OPCABG). The aim of this study was to investigate the short-term effect of "no touch" OPCABG on patients' attention and executive functions. Methods. In this prospective, observational, single-surgeon trial, 74 patients scheduled for elective CABG were studied. Thirty-five patients underwent "no-touch" OPCABG and were compared to 39 patients who underwent "traditional" OPCABG. Subjects underwent neurological and neuropsychological evaluation at the time of admission (7 ± 2 days preoperatively) and discharge (7 days postoperatively). Results. Patients who underwent "traditional" OPCABG showed a significant decline in postoperative performance on 4 neuropsychological tests, while patients treated with "no touch" OPCABG showed a significant decline on 1 test. Twenty patients from "traditional" OPCABG group and ten patients from "no touch" OPCABG group were diagnosed with POCD. Conclusions. Use of "no touch" OPCABG was associated with better attention and executive functions 1 week after surgery compared with "traditional" OPCABG.