Updated June 10, 2015.

By DrRich

Researchers from Duke University have discovered that a simple measure can be instituted to reduce the cognitive impairment after coronary artery bypass grafting (CABG) - a condition known to many surgeons as " pump head." In pump head, patients after surgery note difficulty in concentrating, in doing calculations, increased depression, and other noticeable changes in mental capabilities.

The Duke investigators were also the first to document the existence of, and the frequency of, this condition.

At the recent annual meeting of the Society of Cardiovascular Anesthesiologists, they reported that taking the simple step of spending an extra 10 - 15 minutes in rewarming the patient after bypass surgery can make a significant difference in the incidence of pump head. "Rewarming" is necessary because, during the surgery, while the patient is on cardiopulmonary bypass machine, the body is cooled significantly to help preserve the heart and brain. Toward the end of the surgical procedure, the patient is rewarmed. It now appears possible that, if rewarmed too quickly, the brain's need for oxygen temporarily outstrips the supply, leading to post-operative cognitive difficulties.

What this means to you

If you or a loved one are scheduled for bypass surgery, discuss this issue with your surgeon and anesthesiologist prior to surgery - the precaution of slow rewarming is NOT standard procedure, and it is likely that many if not most cardiac surgery centers are not doing it.

Even if they've heard about this recent report, there will be reluctance to add 10 - 15 minutes to the case. (This is because hospitals tend to compute the cost of surgical procedures by the hour, and adding time to a case will be detrimental to a surgeon's cost profile.) If you don't bring it up, it might well not happen.