Include Disturbances in Learning, Memory, Attention; Pundits Speculate about Bill Clinton's Surgery
MAYWOOD, Ill. - Possible neurologic complications of heart surgery, ranging from headaches to strokes, are detailed in a new report in the online journal MedLink Neurology.
The review article, which compiled results of previously published studies, was written by Dr. Betsy Love and Dr. Jose Biller of Loyola University Chicago's Stritch School of Medicine and Dr. James Fleck of Indiana University School of Medicine.
In the most comprehensive and up-to-date review of its kind, researchers list possible nervous system complications of bypass surgeries, cardiac catheterizations, valve replacements, heart transplants and surgeries for congenital heart disease.
For example, possible complications from bypass surgery include vision problems, paralysis, hoarseness, movement disorders and disturbances in learning, memory, attention, concentration and mental agility. Depending on the age of the patient, operating techniques used and other factors, the risk of stroke ranges from just under 1 percent to as high as 5 percent, studies have found.
"Neurologic complications of cardiac procedures can involve literally any part of the central and peripheral nervous systems," researchers wrote.
Biller said that in cardiac surgery, there's always a risk of neurologic complications, especially in older patients who have other health problems. Biller is chairman of the neurology department at Loyola University Health System and a professor of neurology and neurological surgery at the Stritch School of Medicine.
However, Biller said patients should not be afraid to undergo cardiac procedures. Many complications are rare. And despite the risks, cardiac surgeries generally "are highly beneficial and life saving," he said.
In 2005, 1.3 million angioplasties and 469,000 bypass surgeries were performed in the United States, according to the American Heart Association.
The possible cognitive effects of bypass surgeries have been studied and debated for years. A 2001 study in the New England Journal of Medicine found that, five years after bypass surgery, 42 percent of patients had experienced cognitive decline. Some experts have suggested "pump head" may be the reason -- tiny particles are released into the bloodstream while the patient's heart is stopped and blood is pumped with a machine. The particles trigger tiny strokes. But other experts say any cognitive decline could be due to the underlying cardiovascular disease.
Former President Bill Clinton's recent behavior has brought renewed attention to the issue from reporters, pundits and bloggers. Clinton, who had quadruple bypass surgery in 2004, has shown flashes of anger and made uncharacteristic gaffes while campaigning for his wife, Hillary.
Biller declined to speculate on Clinton's alleged condition because he has not examined the former president. But Biller said the case illustrates the need for patients "to be evaluated carefully in a multidisciplinary fashion."
Based in the western suburbs of Chicago, Loyola University Health System is a quaternary care system with a 61-acre main medical center campus and 22 primary and specialty care facilities in Cook, Will and DuPage counties. The medical center campus is conveniently located in Maywood, 13 miles west of the Chicago Loop and 8 miles east of Oak Brook, Ill. The heart of the medical center campus, Loyola University Hospital, is a 570-licensed bed facility currently undergoing a significant expansion project. It houses a Level 1 Trauma Center, a Burn Center and the Ronald McDonaldÂ® Children's Hospital of Loyola University Medical Center. Also on campus are the Cardinal Bernardin Cancer Center, Loyola Outpatient Center, Center for Heart & Vascular Medicine and Loyola Oral Health Center as well as the LUC Stritch School of Medicine, the LUC Marcella Niehoff School of Nursing and the Loyola Center for Health & Fitness.