Patient-Reported Postoperative Neuropsychological Deterioration After Heart Valve Replacement and Coronary Artery Bypass Grafting

• DOI: 10.1016/j.cjco.2023.11.007
• Publication Date: 2023-11-15T16:52:45Z
• Authors: Marius Butz; Jasmin El-Shazly; Tibo Gerriets; Rolf Meyer; Marlene Tschernatsch; Tobias Braun; Patrick Schramm; Thorsten R. Doeppner; Stefan T. Gerner; Andreas Boening; Yeong-Hoon Choi; Markus Schoenburg; Martin Juenemann
• Keywords: 03 medical and health sciences; Cardiovascular Surgery; 0302 clinical medicine; RC666-701; Diseases of the circulatory (Cardiovascular) system

BackgroundPostoperative cognitive deficits (POCD) after cardiosurgical interventions, are well described through objective psychometric tests. However, patients' subjective perception is essential to clinical assessment and quality of life. This study systematically evaluated patient reported POCD between subjects undergoing coronary artery bypass grafting heart valve replacement.MethodsThis was a multicenter, prospective questionnaire survey conducted at the cardiac surgery departments Kerckhoff Clinic in Bad Nauheim University Hospital Giessen, Germany. We included patients elective (CABG), aortic replacement (AVR), mitral replacement/reconstruction (MVR), combined (CABG+VR) with extracorporeal circulation. The Anxiety Depression Scale (HADS), Cognitive Failures Questionnaire for self-assessment (CFQ-S), external (CFQ-F) were completed preoperatively as 3 12 months postoperatively.ResultsA total 491 available analyses (CABG=182, AVR=134, MVR=93, CABG+VR=82). postoperative depression increase (PODI), observed each surgical procedure (At 3-month follow-up: CFQ-S [CABG=7.1%, AVR=3.7%, MVR=9.7%, CABG+VR=9.8%]; CFQ-F [CABG=9.9%, AVR=9.7%, CABG+VR=15.9%]; PODI [CABG=7.7%, MVR=6.5%, CABG+VR=8.5%]. At 12-months [CABG=6.6%, AVR=7.5%, MVR=15.1%, CABG+VR=7.3%]; AVR=14.9%, MVR=10.8%, [CABG=10.4%, AVR=11.2%, CABG+VR=4.9%]). No significant between-group effects CFQ-S, CFQ-F, HADS.ConclusionsFor clinicians it important pay attention self-reported experiences reduced function symptoms following surgery. an indication that interventions such training or psychotherapy should be considered.