Fighting Coronary Bypass Mental Decline

T O R O N T O, June 26 -- Jim Chapman relies on quick wit and a keen memoryto host his radio show.

But since an emergency heart bypass operation, the host of CJBK-AM Radio's Talk of the Town in London, Ontario, noticed memory loss andmental lapses he has never had before.

"There would be moments when I would forget what to say," Chapman says. "Iknow how the streets run in the city but I can no longer remember theirnames."

He shared his complaint with listeners and found many bypass patients withthe same problem. Recent research has confirmed what Chapman and othershave experienced. Now doctors are trying to prevent the problem.

Research Documents Mental Decline After Bypass

A study in the New England Journal of Medicine in February found that asmany as 42 percent of patients who undergo a bypass may be expected toperform significantly poorer on tests of mental ability five years later.Other effects are personality changes, memory problems and irritability.

The cause is believed to be the tool that allowed the bypass operation sosuccessful.

Doctors stop the heart during surgery and the blood is rerouted through aheart-lung machine. "There is clear evidence that neurological damage occursafter the use of the heart-lung machine," says Dr. Douglas Boyd, a cardiothoracic surgeon at the London Health Sciences Center. "It cannot be ignored by anyone in the field of heart surgery."

When the pump is connected to the patient it can dislodge plaque that hasbuilt up in the arteries, some doctors say.

"If we shower the brain with thousands of these tiny particles, patients maynot have a full stroke, but they may not be as sharp as they once were,"says Dr. John Murkin, an anesthetist at the London Health Sciences Center in Ontario.

Not all surgeons agree that bypass is to blame.

"Remember, these are people who already, before they come to heart surgeryhave some changes in the brain circulation because of atherosclerosis," saysDr. Hugh Scully, a cardiothoracic surgeon of University Health Network inToronto.