Our Summary

This research investigated changes in blood flow in the brain before, during and after heart surgery with a cardiopulmonary bypass, specifically in patients who experienced cognitive problems after surgery. They enrolled 100 patients undergoing heart bypass or valve surgery, and tested their cognitive abilities before and after surgery. They also measured the blood flow in the middle cerebral artery (an important blood vessel in the brain) at several points before, during and after surgery, and took blood samples to measure levels of a protein that is often used as a marker for brain damage.

Of the 100 patients, 86 finished the study. They found that the blood flow in the middle cerebral artery was lower in the group of patients who experienced cognitive problems after surgery, both after anesthesia was given and during the bypass procedure, compared to those who did not have cognitive issues. The blood flow during the bypass was found to be a good indicator of who would experience cognitive problems after surgery. However, they found no significant connection between the levels of the brain damage protein and the cognitive test results or blood flow in the middle cerebral artery.

In other words, this study suggests that monitoring blood flow in the brain during heart surgery could be useful for predicting which patients might have cognitive problems after surgery. However, measuring levels of a certain protein in the blood is not helpful for diagnosing these cognitive issues.

FAQs

  1. What was the main focus of this research about heart bypass surgery?
  2. How does blood flow in the middle cerebral artery relate to cognitive problems after heart bypass surgery?
  3. Why did the study find that measuring levels of a certain protein in the blood was not helpful for diagnosing cognitive issues after surgery?

Doctor’s Tip

A helpful tip a doctor might give a patient about heart bypass surgery is to discuss with their healthcare team the importance of monitoring blood flow in the brain during the procedure to potentially prevent cognitive problems post-surgery. It is important for patients to be proactive in advocating for their own care and discussing any concerns or questions they may have with their medical team.

Suitable For

Patients who are typically recommended for heart bypass surgery include those with severe coronary artery disease, blockages in multiple coronary arteries, or those who have not responded well to other treatments such as medication or lifestyle changes. Additionally, patients who are at a high risk for heart attack or other complications due to their heart condition may also be recommended for heart bypass surgery.

Timeline

Before heart bypass surgery:

  • Patient undergoes a series of tests and evaluations to determine the need for surgery
  • Patient may be prescribed medications to prepare for surgery
  • Patient receives preoperative instructions and guidance on what to expect during and after surgery

During heart bypass surgery:

  • Patient is put under anesthesia
  • Surgeon makes an incision in the chest to access the heart
  • Blood flow is redirected through a heart-lung machine to bypass the blocked arteries
  • Surgeon performs the necessary repairs or bypasses on the heart

After heart bypass surgery:

  • Patient is monitored in the recovery room for a period of time
  • Patient is given pain medication and antibiotics to prevent infection
  • Patient is encouraged to start moving and walking as soon as possible to aid in recovery
  • Patient undergoes postoperative follow-up appointments to monitor progress and address any concerns

In the weeks and months following heart bypass surgery:

  • Patient continues to recover and regain strength
  • Patient participates in cardiac rehabilitation to improve heart health and overall fitness
  • Patient may experience cognitive issues, such as memory problems or difficulty concentrating
  • Patient may continue to see their healthcare team for ongoing care and monitoring of their heart health.

What to Ask Your Doctor

Some questions a patient should ask their doctor about heart bypass surgery include:

  1. How will my cognitive function be monitored during and after surgery?
  2. What measures will be taken to ensure proper blood flow to my brain during the bypass procedure?
  3. Are there any specific risk factors that could increase my chances of experiencing cognitive problems after surgery?
  4. How common are cognitive issues after heart bypass surgery, and what is the typical recovery process?
  5. Are there any steps I can take before surgery to reduce my risk of cognitive problems?
  6. Will I have access to a neurologist or cognitive specialist during my recovery period?
  7. What are the potential long-term effects of cognitive issues after heart bypass surgery?
  8. How will my overall brain health be monitored post-surgery?
  9. Are there any specific cognitive exercises or therapies that can help improve cognitive function after surgery?
  10. How will my medication regimen be adjusted to support cognitive health during recovery?

Reference

Authors: Bukauskienė R, Širvinskas E, Lenkutis T, Benetis R, Steponavičiūtė R. Journal: Perfusion. 2020 Oct;35(7):672-679. doi: 10.1177/0267659120906045. Epub 2020 Feb 19. PMID: 32072860