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Good News for Heart Bypass Surgery Patients
April 25, 2005 -- There is reassuring evidence that having surgery to help your heart does no lasting harm to your brain.
In the most comprehensive review to date, no support was found for a link between heart bypass surgery and long-term memory loss or other mental declines. The heart bypass surgery was associated with short-term memory loss, however.
"We believe most patients who experience cognitive decline [following heart bypass surgery], will return to their baseline by three months or sooner," says Johns Hopkins School of Medicine neuropsychologist Ola A. Selnes, PhD.
Declines Probably Due to Other Causes
Heart bypass surgery involves rerouting blood around clogged arteries to improve the supply of blood and oxygen to the heart.
Researchers from Duke University first raised concerns about the long-term impact of having the surgery on memory and mental function in a highly publicized study five years ago. The researchers reported that well over a third of patients still had measurable mental decline five years after having heart bypass surgery.
But it was not clear if the declines were caused by the heart bypass surgery, the heart disease that prompted the surgery, or by natural aging.
The new review, published in the May issue of Annals of Neurology, was conducted by Selnes and Johns Hopkins neurologist Guy M. McKhann, MD. The two have long studied the impact of heart bypass surgery on mental function.
They concluded that the research confirms the existence of mild memory and other thought problems lasting up to three months after surgery, possibly due to short-term disruption in blood flow to the brain or to the effects of anesthesia.
They found no evidence linking the heart bypass surgery to long-term mental impairment, however.
"There is no question that immediately after surgery people can have trouble, primarily with issues of memory," McKhann tells WebMD. "But our feeling is that any long-term declines are probably related to underlying vascular disease and not to surgery."
But McKhann says the question will probably not be answered for good until the results of several ongoing studies, including one that his research team is conducting, are reported in one or two years.
The studies are comparing long-term cognitive outcomes among heart bypass surgery patients, patients with heart disease treated without surgery, and a comparison group without heart disease. The idea is to determine if mental declines are caused by the surgery itself, by underlying heart disease, or by aging alone.
In the meantime, Delaware heart surgeon Timothy Gardner, MD, says the newly published review should reassure both prospective heart bypass surgery patients and their doctors. Gardner is medical director of the Center for Heart and Vascular Health at Wilmington's Christiana Care and is a spokesman for the American Heart Association.
"A lot of people in the field and outside of it have accepted the idea that heart surgery can cause permanent injury to the brain, so this can be seen as very reassuring," he tells WebMD. "Especially since the people who conducted this review are experts in the field."
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