European Stars and Stripes (Newspaper) - February 27, 1990, Darmstadt, Hesse                                New concerns Over heart bypass by Sandra Blakeslee new York Timas preliminary results of an International study show that coronary bypass surgery produces Subtle Long lasting impairment d menial performance in nearly one m five people who undergo i he operation while scientists say the problem is not seriously debilitating. Patients often report trouble concentrating remembering new Anlo Nealton and performing mental tasks As quickly As they could before their operations the study found that the rouble persisted in t7 percent of the parents a year Aller surgery the study is also finding that up to 20 percent of bypass patients Are depressed one year after their operations and that their mood change stemmed from damage sustained in surgery. Some parents suffer both depression and mental difficulties yet others become depressed for purely psychological reasons which Are not directly associated Wilh the surgery the findings Are far from definitive and their significance is not yet certain. The study has thus far enrolled about 600 patients but has followed Only about 150 of them. Aft in Europe for a year after their surgery they Are a Small portion of the 1,000 bypass patients who Are ultimately to be evaluated for Long term mental impairment by the time the study ends in 1992 the design of the study has been questioned by some experts and the results seem to contradict dozens of other studies that have looked for Subtle brain damage without finding any Long lasting effects Bui the researchers conducting the study say that <1 identifies a problem that escaped the methods used in earlier studies some american heart surgeons have expressed scepticism that the in dogs will hold up and Many say that physicians and patients should not be unduly alarmed by the findings because the effects on menial performance if real Are minor but the new study has been praised by some european specialists who believe that bypass operations May indeed be causing Subtle brain damage that was not previously recognized. Experts behave that surgeons should be made aware of the risk so safer procedures can be devised end that patients should to made aware of the risk so that they can Lake it into account when deciding with variable in the heart bypass machine when a machine takes Over the pumping and oxygenating functions of the heart an Junge researched suspend i change in the Patio Auto and Ita flow can Earl omit Airt part a . Bubble oxygen Tor their doctors whether to undergo bypass surgery. Or. Thorkel Aberg a leading Hearl surgeon at Umea University Hospital in Umea Sweden who is Laking part in the new studies said Quot i have no doubt there is Subtle brain cell damage during these  although Quot these Are Subtle complications that can Only be measured by Neur psychological methods he said the problem should not be ignored. He said. Quot the study is carefully done Quot and Quot the results seem  8ul he added. Quot american surgeons Don l like la recognize this problem wheres european surgeons Are concerned about  bypass surgery is often recommended when one or More arteries that Supply blood to the heart become narrowed depriving heart tissue of oxygen which can cause heart pains or ultimately a heart attack. In the procedure which its performed on about 350,000 americans a year a surgeon removes a Section of a vein or artery from another Pari of the body and sews it in position to bypass the blocked artery. The new research has not determined what causes the mental impairment associated with the procedure but researchers say that various aspects of the bypass procedure could produce the Subtle mental impairments. For example blood fillers used m hear Mung machines that take Over the function of the heart and lungs during the surgery might promote the formation of tiny clots that can plug arteries in the brain and destroy brain cells if they Are deprived of oxygen for More than 15 minutes. Variations in blood pressure blood gases the level Soma Rei Echiri think fillers and tubing Bright cause the blood to nuke tiny Dob that could Block Brofn Martar variations in blood pressure and flow oxygen and cartoon Dot Kef Levels the number of red blood a the and How the patient and blood Are cooled Down and warmed up might also affect the brain s oxygen Supply. Source Mark a vow of red blood celts maintained during surgery and How the patient is cooled and warmed could All ailed the amount of oxygen reaching brain cells said Mark Kurusz. A leading expert on heart lung machines at the University of Texas medical Branch in Galveston. Subtle menial impairment Quot is som Elhag you can measure but t Don t know whether to attribute any importance to it Quot said or. Joseph g. Reves. The director of the heart Center at Duke University medical Center it a Durham North Carolina most patients who experience the problem he said Quot Are Back at work Happy and adjusted Quot and he added Hal the benefits of surgery so clearly outweigh this trivial risk that patients should not worry about it. Or. Joe Utley a heart surgeon from Spartanburg South Carolina who organizes an annual meeting on the  of bypass surgery said he was Quot not Al All surprised Quot that some patients May have Subtle and Long lasting mental impairment because patients who undergo bypass surgery Loday arc older and sicker he Sard they May be predisposed to such damage. Younger patients. Who May be Moro resilient against brain damage tend to be heated with drugs or ies9 invasive techniques for cleaning out clogged arteries he said. Quot the last is that the overwhelming majority of people who undergo bypass surgery have a much higher Quality of life Quot Utley said. 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