Fall 2003 Volume 16, Number 2	A Reprieve for Bypass?
	More than two-thirds of those who undergo coronary artery bypass surgery may have problems in thinking, remembering and learning, and are slower at tasks like writing and drawing immediately following surgery. But -- and it's a major "but," -- neuropsychologist Ola Selnes, Ph.D., along with Hopkins neurology and cardiology colleagues, has discovered these early changes are generally reversible and last no more than three months.
"Casual reports from some patients and their families that they don't function as well cognitively after the surgery have long raised questions," says Selnes. "Several studies showed bypass patients actually did have cognitive decline. But none of the research had proper control groups with a similar cardiovascular status. We wanted something definitive." The study compared 140 patients who underwent bypass surgery with a second group of 92 coronary artery disease patients who did not have surgery. Both groups received neuropsychological tests to measure cognitive abilities - things like attention and verbal memory - as a baseline. Then the surgical group underwent the bypass procedure. Tests were repeated three and 12 months later and compared. "We found there is cognitive decline, but it's transient and reversible," says Selnes. As for changes several years down the road, their link to the surgery remains to be seen. Earlier descriptive work by Selnes and colleagues -- without a control group -- showed surgery patients have a greater than expected decline in certain thought processes five years later. Continuing the present study another five years should clarify if bypass is to blame, or if normal aging, vascular disease and other causes play a part. For more information, call 410-955-3268.