Neuropsychological function before and after cardiac transplantation

A number of studies have demonstrated neuropsychological impairment in patients with cardiac disease who are evaluated in relation to open heart surgery or coronary artery bypass surgery [1–3]. Several studies [4–6] have revealed a high rate of neurological complications in cardiac transplant patients but there has been relatively little investigation of neuropsychological deficits in these patients before or after transplantation. One study [7] evaluated 54 patients with heterogeneous cardiac disease. On an extensive neuropsychological test battery, there was a high prevalence of impaired performance suggesting diffuse cerebral dysfunction. Following transplantation, there were no differences related to the nature of cardiac disease, but there was some evidence that patients over 50 years of age had slightly greater neuropsychological deficit. There were significant improvements on a number of measures, although the magnitude of improvement was interpreted as being of limited practical significance. The improvement in function was unrelated to post-operative emotional status, length of time on cardiopulmonary bypass, and interval between transplantation and post-operative follow- up.