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Eur J Cardiothorac Surg 1998;13:13-20
© 1998 Elsevier Science NL

Cerebral functional changes following cardiac surgery: Neuropsychological and EEG assessment¹

^a Department of Cardiothoracic Surgery, Royal Postgraduate Medical School and Hammersmith Hospital, London, UK
^b Department of Psychiatry, University College Medical School, London, UK

Received 2 June 1997; received in revised form 3 November 1997; accepted 11 November 1997.

Corresponding author. Present address. Department of Health and Community Studies, University College Chester, Cheyney Road, Chester CH1 4BJ, UK. Tel.: +44 1244 375444; fax: +44 1244 373379.

Objective: Some form of organic and functional cerebral deficit may occur in up to one third of patients following cardiopulmonary bypass surgery. This study was designed to assess cerebral functional deficit in cardiac surgical patients. Methods: Neuropsychological and quantitative electroencephalographic (EEG) changes were assessed in 62 first time coronary artery bypass graft surgery patients before surgery and within 1 week and 2 months after surgery. Patients underwent surgery with a standard Hammersmith Hospital anaesthesia and hypothermic cardiopulmonary bypass (28°C), using either bubble (Harvey 1700, n=28) or membrane (Cobe CML, n=34) oxygenators with arterial line filters (Pall 40 µm). Neuropsychological performance was assessed using a well established battery of ten tests. Four EEG relative power frequency bands; (1–3.5 Hz), (4–7.5 Hz), (8–11.5 Hz), and ß (12–23 Hz), were determined using Fast Fourier Transformation (FFT). Results: Neuropsychological and EEG deficits were found in 48% of patients 1 week after surgery and in 34% 2 months after surgery. Post-operative deficits were not associated with duration of perfusion, type of oxygenator used in surgery or patient age. Neuropsychological and EEG deficits were associated 2 months after surgery, but not 1 week after surgery. Post-operative EEG deficit was associated with pre-operative deficit. Conclusions: Cerebral functional deficit was found following CABG surgery using quantitative EEG and neuropsychological assessments. Patients who had neuropsychological deficit were also more likely to show EEG deficit. EEG deficit before and after surgery suggests vulnerability of patients with already compromised cerebral function to the effects of CPB procedure.

Key Words: Quantitative EEG • Brain damage • Neuropsychological deficit • Cardiac surgery • CABG • (Human)

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