Please use this identifier to cite or link to this item: http://hdl.handle.net/11434/33
Title: Effects on cognition of conventional and robotically assisted cardiac valve operation
Epworth Authors: Almeida, Aubrey
Other Authors: Bruce, Kathryn
Yelland, Gregory
Smith, Julian
Robinson, Stephen
Keywords: Cardiac Surgery
Robotics
Cognition
Cardiothoracic Surgery Unit, Epworth Hospital, Melbourne, Victoria, Australia.
Valve Surgery
Robotic Surgery
Thoracic Surgery
Mood State Assessment
Intelligence Quotient
Cognitive Testing
Aortic Valve
Cognition Disorder
Risk Assessment
Issue Date: Mar-2014
Citation: Ann Thorac Surg. 2014 Jan;97(1):48-55
Abstract: BACKGROUND: The effect of valve surgical procedures on cognition was investigated in patients undergoing conventional or robotically assisted techniques. The confounding factors of surgical procedure, mood state, preexisting cognitive impairment, and repeated experience with cognitive tests were controlled for. METHODS: Patients undergoing conventional valve procedures (n = 15), robotically assisted valve procedures (n = 15), and thoracic surgical procedures (n = 15), along with a nonsurgical control group (n = 15) were tested preoperatively, 1 week after operation, and 8 weeks after operation by use of a battery of cognitive tests and a mood state assessment. Surgical group data were normalized against data from the nonsurgical control group before statistical analysis. RESULTS: Patients undergoing conventional valve procedures performed worse than those undergoing robotically assisted valve procedures on every subtest before operation, and this disadvantage persisted after operation. Age and premorbid intelligence quotient were significantly associated with performance on several cognitive subtests. Anxiety, depression, and stress were not associated with impaired cognitive performance in the surgical groups after operation. A week after operation, patients undergoing conventional valve procedures performed worse on the cognitive tests that had a motor component, which may reflect discomfort caused by the sternotomy. Patients undergoing robotically assisted valve procedures were significantly less impaired on information processing tasks 1 week after operation when compared with those undergoing conventional valve procedures. The majority of patients who were impaired 1 week after operation recovered to preoperation levels within 8 weeks. CONCLUSIONS: The robotically assisted valve surgical procedure results in more rapid recovery of performance on cognitive tests. However, regardless of the type of surgical intervention, the prospect of a recovery of cognitive performance to preoperative levels is high.
URI: http://hdl.handle.net/11434/33
DOI: 10.1016/j.athoracsur.2013.07.018
PubMed URL: http://www.ncbi.nlm.nih.gov/pubmed/24075495
ISSN: 0003-4975
Journal Title: The Annals of Thoracic Surgery
Type: Journal Article
Affiliated Organisations: Blood-Brain Interactions Group, School of Psychology and Psychiatry, Monash University, Melbourne, Victoria, Australia.
Department of Cardiothoracic Surgery, Monash University, Melbourne, Victoria, Australia.
Department of Surgery, Monash University, Melbourne, Victoria, Australia.
Australia School of Health Sciences and Health Innovations Research Institute, RMIT University, Melbourne, Victoria, Australia.
School of Health Sciences and Health Innovations Research Institute, RMIT University, Melbourne, Victoria, Australia.
Type of Clinical Study or Trial: Case Controlled Study
Appears in Collections:Cardiac Sciences

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