Friday, October 12, 2018

Heart Valve Surgery May Lead to Postoperative Cognitive Deficits

Patients who undergo heart valve surgery are at a heightened risk of cognitive decline in the first few months after surgery, suggests a paper published yesterday in the Journal of the American Geriatrics Association.

“Aortic valve surgery, which is performed more commonly in older adults, entails greater risk of early cognitive dysfunction within the first month after surgery than mitral valve surgery, but cognition in both groups appears to converge by six months,” wrote Mark Oldham, M.D., of the University of Rochester Medical Center and colleagues.

Oldham and colleagues conducted a meta-analysis of 12 clinical studies that had assessed the cognitive scores of adults before and after undergoing heart valve surgery. A total of 12 clinical studies, which included 450 patients who had early cognitive assessments (one week to one month after surgery) and 722 patients with intermediate assessments (two to six months after surgery), were included in the analysis. The researchers identified no studies that explored long-term cognitive changes after heart valve surgery, which they noted is a major research gap.

The analysis revealed that patients who underwent heart valve surgery experienced moderate cognitive decline in the first month after surgery that improved slightly by six months out. Patients who underwent mitral valve surgery experienced mild but progressive decline over six months, while those who underwent aortic valve surgery had greater early cognitive dysfunction, followed by partial recovery. The authors noted that patients receiving aortic valve surgery were about 11 years older on average, which could have influenced these outcomes.

“These findings call for further investigation aimed at refining risk stratification and prevention strategies in this group, in which cognitive vulnerability is widely underrecognized,” Oldham and colleagues concluded.

To read more about this topic, see the Psychiatric News article “Escitalopram May Reduce Risk of Heart Problems.”

(Image: iStock/kupicoo)


The content of Psychiatric News does not necessarily reflect the views of APA or the editors. Unless so stated, neither Psychiatric News nor APA guarantees, warrants, or endorses information or advertising in this newspaper. Clinical opinions are not peer reviewed and thus should be independently verified.