RESUMO
Improvement of cardiosurgery treatment and perioperative care of CABG (coronary artery bypass grafting) patients has been associated with essential reduction of early mortality. Nevertheless neurological complications have not changed. Cerebrovascular death, stroke, encephalopathy and cognitive decline remain the most common disturbances. Cognitive impairment after CABG seems to be a multifactorial problem. Demographic, medical history and perioperative factors strongly influence cognitive outcome. Incidence of decline is common immediately after surgery (53-79%), less frequent after 6 months (10-30%) and it depends on cardiosurgery method (on-pump > off-pump surgery). Early impairment is the predictor of late cognitive deficit in the 5-year follow-up. Microembolic signals, cerbral hypoperfusion and systemic inflammatory response are the main reasons of damage. Neuropsychological tests consist of verbal and non-verbal memory, visuo-spatial and construction abilities, motor speed, language and executive functions evaluation. It is proposed to perform examinations before the operation and at least 3 months after CABG Twenty per cets or 1 SD decline in at least 20% of tests will be significant. Anxiety and depression signs should be taken into consideration as well.
