Does heart valve surgery affect the cognition of older people?

In a new journal, researchers looked at previous studies of patients with open-heart surgery to determine whether they had a tendency to experience a difference in cognition after the procedure. Specifically, they examined two types of cardiac, mitral and aortic valve surgery to see if each was associated with better or worse cognitive outcomes.

Their conclusions are published in the Journal of the American Geriatrics Society.

Most people requiring aortic valve surgery are over 65 years old and the number of older adults with aortic stenosis is expected to double by 2050. It is very important to understand how heart valve surgery can affect the cognition of an elder.

For this study, researchers examined 12 previous studies including hundreds of people who had heart valve surgery. In each study, participants were tested before and after the surgery to determine their ability to remember, reflect and make decisions.

The results reveal that in the first month after valvular surgery, study patients experienced some cognitive decline from their preoperative state.

However, until six months after surgery, patients' cognitive health was generally back to normal. One-third of the studies included in this review even showed slight improvements in cognition six months after surgery.

Aortic stenosis is the most common condition requiring valvular surgery. The aorta is the heart valve that controls the blood flow from the heart to the rest of the body. Aortic stenosis occurs when the aortic valve does not allow the blood to flow properly from the heart.

The researchers found that aortic valve surgery was associated with more early cognitive problems than mitral valve surgery.

Patients who had undergone mitral valve surgery experienced a slight decline from their balance sheet from one month to their checkups two to six months after surgery. But those who had undergone aortic valve surgery had lower cognitive function the month following the operation, although they tended to improve thereafter.

Importantly, however, aortic valve patients averaged a decade longer than mitral valve patients (68 versus 57). As such, the increased age of patients having aortic valve surgery might have affected their cognitive decline more importantly.

The researchers concluded that patients who had cardiac valve surgery could have cognitive problems up to six months after the operation. Patients undergoing aortic valve surgery – the majority of whom are elderly – are at greater risk of early cognitive decline in the first month after surgery than those undergoing mitral valve surgery. However, cognitive health in both groups appears to largely return to its pre-surgery status within six months of surgery.

Source: American Geriatrics Society

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