Effect of cardiopulmonary bypass to cognitive functions on pediatric cardiovascular surgery patients

Objective: The aim of our prospective study was to investigate the effects of cardiopulmonary bypass surgery on cognitive functions of patients who were diagnosed as congenital heart disease.Material and Methods: in the study group, Twenty five cases (6-17 years old) without any systemic and neurolojik disease (hypertension, diabetes mellitus, mental retardation) or story of previous surgical intervention, who will have cardiopulmonary bypass becouse of congenital heart disease and forty cases of healty children as control group were included.Whecsler Intelligence Scale for Children Revised (WISC-R), Stroop Test, Visual Auditory Digit Span Test Fom B (GISD-B), Bender Gestalt Test (BGT) were applied to all children in two groups by an experienced neuropsychologist. Cognitive functions of all children in two groups were evaluated 1-3 days before surgery and 7-18 days after cardiopulmonary surgery.Results: Effect of cardiopulmonary surgery on neurocognitive functions such as visual motor development, visual spatial memory and visual organization, visual perception, multimodal short term memory, concentration, selective attention and rate of information processing were not found at significant level in children with congenitalheart disease. On the contrary, in comparison of Visual-Auditory Digit Span Test-B (VADS-B) scores between before and after surgery, there was found significant positive effect of short term memory for subtest component. This finding is due to the effects of the test-retest.Children with congenital heart diseases were found poorer performance for selective attention, visual spatial perception, visual motor coordination than healthy children in control group. Additionally, positive correlation was found between neuropsychological test performance and risk factors which include minimum pH and hematocrit level, duration of cardiopulmonary bypass and duration of extubation.Conclusion: In conclusion, short term negative effects of cardiopulmonary bypass surgery on neurocognitive functions were not detected in children with congenital heart diseases. We consider that these data are important in counseling families about outcomes of surgery and contributing the ongoing debate on cognitive effects of surgery.Key words: Congenital heart disease, cardiopulmonary bypass, cognitive functions