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S32 Heart, Lung and CirculationMODERATED POSTERS 2007;16:S31–S38
Figure 1. Variable life-adjusted display (VLAD) with control limits mapped from RA-CUSUM. The upper and lower control limits correspond to ahalving and doubling of the odds of death, respectively. The upper control limit signals after case 161 in this series.
DETERMINING COGNITIVE CHANGE AFTER CABGAND VALVE REPAIR/REPLACEMENT SURGERY
Kathryn Bruce 1, Stephen Robinson 1, Greg Yelland 1,
Aubrey Almeida 2, Julian Smith 2
1 School of Psychology, Psychiatry & Psychological Medicine,Monash University, Melbourne, Australia2 Department of Surgery, Monash Medical Centre, Melbourne,Australia
Introduction. Coronary artery bypass grafting (CABG)and valve repair/replacement surgery are known to beassociated with cognitive impairment, but it is not clearwhether these impairments exist prior to surgery, orwhether these impairments are a transient result of thesurgical procedure. Furthermore, little is known aboutthe cognitive effects of robotically assisted valve surgery.This study examines the incidence of cognitive deficitsin these patient groups using a novel computer-basedtask and a series of ‘gold standard’ neuropsychologicaltests.
Method. Four surgical groups were included: on-pumpcoronary artery bypass surgery, valve repair/replacement,robotically assisted valve repair, and a thoracic surgicalcontrol group. Participants were assessed preoperatively,4–7 days postoperatively and 6 weeks postopera-tively. Neuropsychological evaluation included measures
CABG patients demonstrated impaired cognition beforesurgery, became significantly more impaired followingsurgery and remained impaired six weeks postoperatively.By contrast, the valve repair/replacement and robotically-assisted valve surgery groups displayed better cognition atadmission, experienced some impairment one week aftersurgery but had returned to preoperative levels within sixweeks.
Discussion and conclusion. Our results show that CABGpatients have impaired cognition prior to surgery and thatthis impairment increases after surgery. It seems likelythat the cardiovascular disease in the CABG group isthe cause of this impairment. Further studies are neededto ascertain whether cognitive function is restored afterlonger recovery periods. The fact that both of the patientgroups who received valve surgery demonstrated a simi-lar transient impairment in cognition indicates that bothsurgical techniques provide an equally positive cognitiveoutcome for the patient. However, it is not yet knownwhether both forms of surgery are associated with equallygood cognitive outcomes at longer recovery times.
doi:10.1016/j.hlc.2007.02.042
IMPACT OF COMPLETE REVASCULARISATION ONHOSPITAL AND LONG-TERM SURVIVAL AFTERCORONARY ARTERY BYPASS GRAFTING IN OCTO-
assessing information processing (computer-based task),verbal learning and memory (auditory verbal learningtask), complex visuo-motor coordination (grooved peg-board), visuo-spatial ability and memory (complex figuretask), and word fluency (controlled oral word associationtask).
Results. The groups did not differ in age, educationor pre-morbid IQ. The levels of depression, anxiety andstress at each of the testing sessions did not differ sig-nificantly between any of the surgical groups at any ofthe testing sessions. Data from our cognitive test bat-tery revealed that compared to the thoracic control group,
GENARIANS
E.K. Slimani, R. Baker, J.L Knight
Department of Cardiac and Thoracic Surgery, Flinders MedicalCentre, Bedford Park, SA, Australia
Introduction. Complete revascularisation is an impor-tant predictor of hospital and long-term survival inyounger patients undergoing coronary artery bypassgrafting. This principle, is however less conclusive in anelderly patient population. The purpose of this study wasto ascertain whether complete revascularisation produced
