Cognitive effects of heart lung machine

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I am full of questions!

My cardio has recently brought up the surgery option. I think my greatest fear is the possible decrease in cognitive ability after surgery using a heart lung machine. I have read one reference to this, but would like to find more information. I don't know if this possible decrease is short term or permanent.

I am 65 and have a history of Alzheimer's on both sides of my family. I don't think I am a candidate for either minimally invasive surgery or beating heart surgery as probably both mitral and aortic valves may need to be replaced.

Thanks for any help or input.

Pat
 
Some of us think we may have experienced brief, short term memory loss. I have had two OHS, both on pump, and I think the first weeks after my first surgery, I had a bit of 'pumphead' as some of us affectionately refer to it. I didn't notice it so much my second surgery, last February.

I do not think I have any lasting remnants of it.
 
Pat really it's a nonissue. Temporary at best, but not lasting. Now if your already have the beginnings of impairment of that nature, it may make it worse, but all in all, it's a nonissue.
 
I'm no expert on the cognitive effects so all I can do is relate my personal experience on what has become affectionally known as "pump head". If you search "pump head" on this forum you'll probably find all sorts of threads on this subject.

Anyway, for about a year post-OHS I found myself forgetting names or losing my train of thought mid sentence. However with time it subsided and I think it's pretty much gone now. I still forget stuff but I think it's more from just plain "getting older" than the OHS. The kind of work I do requires a lot of thinking, research, and recall of information from multiple sources and I'm not having any difficulty with that. Accordingly, my experience with "pump head" was temporary not long term. Best wishes and good.
 
I really found no difference after the surgery (and I was on the pump for 2 hours). I was absent minded before, and I am still absent minded. By the way, even if you were to have minimally invasive surgery, you are still on the pump.
 
Uhhhhhhh... what was your question again? :D

Seriously, it doesn't seem to be that big an issue. If there were some predisposition to Alzheimer's, I don't think heart-lung machine time would affect that.

The possibility of impact presumably could increase though if a patient were on the heart-lung machine an inordinately long time. That's one reason my cardio suggested the surgeon I selected -- because he is so proficient with this type of surgury, he does it without delay. So the most important thing to do is to select an excellent surgeon who has done this type of surgery successfully many times.
 
I found I actually lost more brain cells during my A-Fib,cardioversion cycles,,(which there were 3 over 2 years before they gave up),than I did after 2 OHS. Now its just part of the aging thingy. It doesnt embarass me anymore at all to tell someone I recognize their face but dont recall their name. That way we can hug and share memories. oh,,and I do own stock in post its!
 
Pat -

You will be interested in a similar thread from 3 weeks ago in the Post Surgery Forum, entitled "Cognitive Impairment after Aortic Valve Replacement" http://www.valvereplacement.com/forums/showthread.php?p=332280&highlight=cognitive#post332280

In particular, read my reply (#3) and the one from Bob H (aka Tobagotwo - #10), especially the parts about Filter Quality and the rate of Reheating the Body after surgery. Body temperature is usually lowered (to around 25? degrees Centigrade) during surgery. Reheating too fast CAN cause cognitive impairment.

'AL Capshaw'
 
I don't know if your really on the pump longer with davinci. I'm not going to say i know for sure, but can just speak from my own experience. Davinci is the same surgery they would do if they cut you open. The "longer" time your speaking of i think is the time it takes them to set up the machine. But your not on the pump during that time, so i don't see how that would be an issue. But like i said, i don't know for sure.
 
So how is your sense of smell? They say diminished sense of smell may be a precursor to Alzheimer's. How did it go with your family members? Did they experience a long decline?

My father, who recently died of Alzheimer's (well, suspected) had a triple by-pass at age 77. He was very very confused for several weeks. He got his old self back, but then honestly, this was the beginning of his decline. When he passed last May he was very ill with the mental disorder of Alzheimers, while physically very healthy (although it was something sudden physical that took him down in the end). I don't think they were using filters or protective procedures in 1997. HIs mental demise cannot really be attributed to the heart-lung machine. Rather, because he was probably already afflicted with the disease, this may have affected him more strongly.

I think, if I were you, I would try to get some kind of assessment regarding the Alzheimer's before you undertake the surgery. Wouldn't that just be calming for you? I don't know if there is anything anyone can tell you, but if it were me, I would investigate any kind of early assessment possible. At least maybe they could get some kind of a baseline in case after the surgery you had some difficulty. Every day the meds are getting better for this awful disease. Be proactive about it. Go beyond your questions here.

When you say your cardio has mentioned surgery, could you let us know how close you are to needing surgery?

Nowadays, there doesn't seem to be much of an issue with pump-head beyond the temporary glitches that fall into place sometimes. After a year, I am back to full if not better cognitive ability....I finally have some oxygen going to my brain!!! :p

Good luck. Keep us posted.

Marguerite
 
we discussed this over and over from the time the 'syndrome' question came out. about 7 yrs ago. nobody has ever confirmed it at all. we have some who swear by it; others who debunk it altogether. This is also true among doctors.

I have trouble with names. this morning I called my granddaughter, her husband answered, I couldn't remember his name for heck! But I do know his name, really I do.

I wasn't THAT old when I had bypass surgery, but am now, so I do some brain games each morning just to keep mentally active and to check out how my day is going to be. I continue to do business as usual, my mathmatical mind works as well or better than it used to and all seems to work well most all the time - except for names.

Doctors, generally, think that if pumphead is true, all goes back to normal, given time.

Of all the members here in VR, there are many that were here when I came on board in 2000 and they are all still perking along, some even smarter than they were back in 2000.
 
I worried about pumphead a lot, in advance of the actual event. When I was in the ICU and had just come off the vent, I overheard my hubby talking and let him know what the confirmation # was for our return flight: that's when I knew I'd be ok (which is not to say I remember everyone's name even now)
 
I think "Pump head" is real for some of us. I was on the heart lung machine for a long time according to my surgeon. A couple weeks after surgery I was unable to introduce my wife to a friend because I could not remember her name:eek: (we have been married 29 years). Thank goodness this only happened once. I do not know if it was the heart lung machine or all the drugs they pumped into me but it took me awhile to get back what for me was normal. Frankly I was so happy to have climbed the mountain that a little forgetfullness was ok with me. Sometime it came in handy.:)

Another point is that there is a lot that I do not remember after surgery. A friend of mine who assisted with the surgery said that some of the drugs have an amnesia effect on most patients.
 
From Pairodocs-Laura

From Pairodocs-Laura

Chris was so critical, he had to have the surgery, risk of pumphead or no. The surgeon knew I was a physician when I was getting the informed consent, but the alternative was death. I remembered only after the surgery when I had time to think about the cognitive problems. Pumphead is not the only one. There is a risk for stroke and also a type of encephalopathy. I actually saw a man afflicted with the encephalopathy after his OHS. This man was younger than my husband; he kept trying to get out of bed to use the bathroom and actually managed to get out of his room before enough help got there to wrestle him back into bed. Chris was still on the vent, and I started asking a lot of questions, wondering if we were going to experience the same problem. The surgeon and the charge nurse reassured me that most of the folks who suffer the encephalopathy recover completely, and 3 months later, you can't tell they ever had it. The surgeon also told me that Chris had a 15% chance of dying, even if the surgery had gone perfectly; a sobering thought, but the odds improved hourly. I'm glad I didn't know that prior to surgery! There was all the other stuff that could happen, but Chris came through like a champ, with lots of prayer and good care.

There does seem to be a connection between time spent on the heart-lung machine and the development of these problems, according to the surgeon. They are talking about numbers like 4 hours compared to 2, however. Remember that there are cognitive deficits that occur after prolonged anesthesia, and therefore the machine may not be totally to blame.

As soon as we got home, Chris just had to work out a few calculus problems and chemical formulas just to reassure himself that he did not have pumphead. He did fine. Alas, he can't blame his absent-mindedness on pumphead; he had it before his surgery!

Believe me, your staff will be experienced at this. Ask all the questions you can!

Chilly in Idaho,
-Laura
 
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