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EELS (Ethical, Economic, Legal & Social) Article

I have forgotten ever having undergone heart surgery…

The Pharmacogenomics Journal volume 8, pages 1–3 (2008)Cite this article

Sad though it is, despite stroke and other major complications, mild neuro-psychiatric disturbances frequently occur after surgical interventions. Post-operative cognitive decline (POCD) is considered a transient condition, and it may be associated with technically any type of operation, regardless of its duration, ‘severity’ or any other surgical variables.1 POCD, therefore, is just as common after routine appendectomy as it is with major operations, such as esophagectomy or heart surgery.

In contrast with non-cardiac interventions, however, a higher incidence rate of more permanent post-operative cognitive disturbances is characteristic for heart operations.2 This may in a small portion of cases be attributable to developing vascular dementia. Indeed, patients with coronary artery disease have atherosclerotic plaques not only in their hearts, but also ubiquitously in their bodies, including the brain. Just as these pathologic deposits in the arterial intima lead to myocardial infarction, they may also produce scattered microscopic brain lesions, causing vascular dementia (VD). Micro-embolisms during coronary artery bypass grafting (CABG) may further the pre-existing ischemic brain damage to yield multiple ‘micro-strokes’ resulting in post-operative VD.

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Acknowledgements

This study was sponsored by Asklepios-Med Bt.'

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Authors and Affiliations

  1. Asklepios-Med Bt. (private practice and research center), H-6722 Szeged, Kossuth Lajos sgt. 23, Szeged, Hungary

    A Palotás

  2. Department of Psychiatry, Albert Szent-Györgyi Medical and Pharmaceutical Center, University of Szeged, Szeged, Hungary

    A Palotás

  3. Division of Cardiac Surgery, Center for Cardiology, Albert Szent-Györgyi Medical and Pharmaceutical Center, University of Szeged, Szeged, Hungary

    A Palotás

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  1. A Palotás
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Correspondence to A Palotás.

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The author declares that he has no conflict of interest.

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Palotás, A. I have forgotten ever having undergone heart surgery…. Pharmacogenomics J 8, 1–3 (2008). https://doi.org/10.1038/sj.tpj.6500446

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