Psychological Observations of Patients Undergoing Mitral Surgery

Are we using our brains? Diagnosis of postoperative cognitive dysfunction

“…This October, the Resuscitation Council (Resus(UK)) published the 2010 Resuscitation Guidelines [3]. The European Resuscitation Council [4] and American Heart Association [5] published their own new guidelines on the same day, and other countries will follow suit shortly, in a demonstration of co-operation and transparency that is possibly unparalleled elsewhere in the medical scientific community. The Resus(UK) 2010 guidelines are based on the International Consensus on CPR Science with Treatment Recommendations (CoSTR) [6,7], developed by the International Liaison Committee on Resuscitation (ILCOR), currently co-chaired by Jerry Nolan of the UK and Vinay Nadkarni of the USA.…”

“…Interestingly, the first report of these changes was published within a few years of these pioneering operations [5]. Progress was made with respect to this mild brain impairment: as early as 1957, researchers began to employ batteries of psychometric tasks to aid diagnosis of cognitive deterioration [6].…”

Detection and Elimination of Microemboli Related to Cardiopulmonary Bypass

“…Neurological injury subsequent to heart surgery was first reported in 1954 and was attributed to stress and psychoses related to the procedure. 2 Gilman in 1965, in a series of patients undergoing open heart procedures using cardiopulmonary bypass, postulated an organic origin stemming from reduced cerebral blood flow owing to microemboli. 3 Subsequent research, including that from our group, continues to implicate microemboli as the principal mechanism of neurological injury.…”

Psychological Adjustment Following Open-Heart Surgery

“…These reactions have variously been described by psychiatrists as "acute psychotic reactions, " "con fused states, " "delerium," etc. however, only one of the two types of cardiac surgery, "closed" heart surgery (see .footnote, page 20) has received intensive study (Fox, et al_., 1954;Reiser and Bakst, 1959;Zaks, 1959Zaks, , 1962Butts and Wachtel. 1961;Priest, et al .…”

“…Fox, Rizzo and Gifford (1954) studied 32 patients who underwent mitral commissurotomy. They reported six patients (18.7%) as having "obvious emotional disturbances. "…”