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BACKGROUND AND PURPOSE As a result of advances in surgical, anesthetic, and medical management, cardiac surgery can now be performed on older, sicker patients, some of whom have had prior cardiac interventions. As surgical mortality has declined in recent years, attention has focused on the complications of stroke and encephalopathy after cardiac surgery.(More)
BACKGROUND Previous uncontrolled studies have suggested that there is late cognitive decline after coronary artery bypass grafting that may be attributable to use of the cardiopulmonary bypass pump. METHODS In this prospective, nonrandomized, longitudinal study, we compared cognitive outcomes after on-pump coronary artery bypass surgery (n = 152) with(More)
OBJECTIVE The choice of coronary artery bypass grafting (CABG) as an intervention for coronary artery disease has been clouded by concerns about postoperative cognitive decline. Long-term cognitive decline after CABG has been reported, but without appropriate control subjects, it is not known whether this decline is specific to CABG or related to other(More)
BACKGROUND Coronary artery bypass grafting has been associated with both early and late postoperative cognitive decline, but interpretation of previous studies has been limited by lack of appropriate control groups. We compared changes in cognitive performance from baseline to 3 years in patients undergoing coronary artery bypass grafting with those of a(More)
P atients referred for coronary revascularization procedures are older and are likely to have more extensive extracardiac vascular disease than those referred for such procedures in the past. Despite these trends, mortality rates for coronary-artery bypass grafting (CABG), without concurrent procedures, have continued to decline. 1 Nevertheless, adverse(More)
BACKGROUND Cognitive impairment after coronary artery bypass grafting (CABG) is well recognized, but previous investigations have been limited by lack of an appropriate control group. We compared changes in cognitive performance at 3 and 12 months after CABG with those in a control group of patients with comparable risk factors for coronary artery disease(More)
BACKGROUND In contrast to perioperative stroke, much less attention has been paid to those with evidence of diffuse brain encephalopathy, presenting as delirium, confusion, coma, and seizures in the immediate postoperative period. OBJECTIVE To determine the incidence, consequences, and predictive factors for encephalopathy and stroke following coronary(More)
OBJECTIVE To determine the long-term (preoperative to 5 years postoperative) and late (1-5 years postoperative) changes in cognitive test performance in patients after coronary artery bypass grafting. SETTING The departments of surgery and neurology at The Johns Hopkins University School of Medicine, Baltimore, Md. PATIENTS A group of 102 patients who(More)
The purpose of this study was to determine whether depression 1 month after coronary artery bypass surgery would be associated with greater cardiac morbidity in patients 5 years later. The cardiac symptom most affected by depression was the recurrence of angina. Factors associated with a return of angina at 5 years were depression measured preoperatively,(More)
BACKGROUND Extracranial internal carotid artery stenosis is a risk factor for perioperative stroke in coronary artery bypass (CAB) surgery. Although both selective and nonselective methods of preoperative carotid screening have been advocated, it is unclear which approach is most clinically efficacious. METHODS Hospital records for 1421 consecutive CAB(More)