This prospective study reinvestigates the effect of asymptomatic carotid artery disease on the cognitive outcome after cardiopulmonary bypass (CPB) (Harrison et al., 1989). Patients (N = 104) scheduled for cardiac surgery using CPB were classified in one of two groups based on the results of a preoperative duplex B mode Dopplcr scan of the internal carotid arteries. All patients received a neuropsychological examination before surgery, 8 days after surgery, and 6 months after surgery (n = 79). When group data are considered, patients showed evidence of selective cognitive dysfunction early after surgery. These dysfunctions were resolved by the sixth postoperative month. We found no indications that the presence of asymptomatic carotid artery disease increased the incidence of cognitive disturbances after CPB or differentially affected the postoperative performance. We conclude that mild to moderate asymptomatic carotid artery disease does not appear to play a major role in the genesis of postoperative neuropsychological sequelae. (JINS, 1996,2, 236–239.)

The preoperative cognitive test performance of 77 candidates for elective open-heart surgery that did not suffer from carotid artery stenosis, was compared with the performance of 37 normal controls. Multivariate analysis of variance, with state anxiety score and depression score as covariates, showed a significantly reduced cognitive performance in the surgical candidates. Post hoc analyses using univariate F tests revealed a significantly impaired word fluency, manual dexterity, verbal learning, and psychomotor speed. A stepwise multiple regression analysis revealed that, besides the usual demographic factors, preoperative variables indicating a more precarious heart function also contributed significantly to the estimation of the proportion of variance of the results on several impaired cognitive tests. Future research should focus on the etiology of the cognitive impairment in cardiovascular disease. (JINS, 1997, 3, 480–484.)