Pumphead? Cognitive Decline After Heart Surgery?
On the topic of cognitive decline after heart valve surgery, Dan and I just had the following email exchange:
Dear Adam,
I recently purchased your book and have been reading your newsletter. I find both very helpful and encouraging. I thank you for your efforts and concern for others who are going through experiences similar to yours.
I am 50 years old and, as a result of childhood Rheumatic Feaver, will be facing mitral valve surgery soon. Of course, I have many fears and concerns, most of which were discussed in your book. I do have one, follow-up concern that I would like to ask you about. I have heard and read about the phenomenon of cognitive decline following heart valve surgery. I would appreciate any information that you might have on this subject.
Thank you very much. Dan
MY RESPONSE TO DAN:
Hi Dan,
My gut tells me you are inquiring about a condition commonly referred to as “pumphead”. You should know that there are two schools of thought on the impact of bypass specific to the patient’s cognitive capability. Here is some additional information to help you:
- Click on this link to learn more about pumphead.
- Click on this link to learn more about a recent study which questions the reality of pumphead.
Personally, my brain is functioning very well following my open heart surgery in which my aortic and pulmonary valves were replaced. However, I did experience cardiac depression (which was not fun). I was on the heart-lung machine for about two hours.
As for other patients… I will share with you that I have had several conversations with patients and/or their caregivers that do express slower brain function and cardiac depression after heart surgery.
I hope this helps you better understand the potential impact of bypass surgery, cardiac depression and pumphead.
Keep on tickin!
P.S. To post a comment for Dan or offer a general thought, please click here.
Adam Pick is a double, heart valve surgery patient and author of The Patient’s Guide To Heart Valve Surgery, a unique book which integrates the clinical facts of heart valve surgery with the personal experiences of an actual heart valve surgery patient. To learn more about Adam and his heart valve surgery book, click here.
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September 5th, 2008 at 2:47 pm
Dan — I had mitral valve repair in March of this year. I too had read about “pumphead,” but never experienced it.
On the other hand, I did experience depression, and in retrospect, would go on an antidepressant BEFORE the surgery to help alleviate that whole experience. My cardiologist told me, AFTER the depression had lifted, that he was taught in school to start open heart patients w/ antidepressants before their surgery, but in his practice now, he’s not “allowed” to prescribe antidepressant med prior to surgery. Yipes.
Good luck w/ your procedure. You’ll do fine. If you’ve ever had a scratched cornea, I’m here to tell you that that hurts way more than this surgery.
September 5th, 2008 at 3:31 pm
Hi Dan.
If it happens to you, it’s temporary. I h d a mitral valvuloplasty a few years back also because of childhood rheumatic fever (and am now facing valve replacement), and, although I appeared and sounded normal, I knew that my brain was a bit foggy. It lasted for 3 months, during which time I was generally thinking okay, and occasionally felt almost like brain tired. It only lasted three months, like I said, so don’t worry. At least you know in advance that it might happen.
Good luck with your surgery.
Laura
September 11th, 2008 at 11:05 am
Dan,
My wife had minimally invasive aortic valve replacement surgery on March 19th this year. It took about 6 hrs. She did suffer from “pumphead” and it was noticable to family and friends. Unfortunately the replacement valve did not solve her genetic abnormalities in the heart and the aortic artery and she had to undergo the full open chest operation on August 6th. This time the operation took 9.5 hrs and the heart and aortic artery were enlarged to allow easier blood flow. It has been just over 4 weeks since the surgery and she is doing great and doesn’t seem to suffer from the “pumphead” that she did after the first surgery.
Good luck!
John
November 19th, 2008 at 2:17 pm
I had an aortic valve replacement for my severe stenotic bicuspid valve and graft of my aortic root and ascending aorta due to a 5 cm fusiform aneurysm 8 weeks ago. I was on the table for 7-8 hours. A week and a half later (after having gone home) I was rushed to the local ER with a pericadial effusion and a pleural effusion with partial lung collapse, and was transfered back to the hospital where I’d had my AVR and graft for yet another surgery, much shorter this time. I have continuing cognitive fuzziness but my idea is that it might be a combination of “pumphead”, the anaphlactic (sp?) shock during my first heart surgery to an new antibiotic, and all the anesthesia and all the other meds they gave me, including the insulin I was given before each meal, even though I ate barely enough to compensate. (I’m not diabetic but I was given something during the AVR surgery that caused my pancreas to flip out a bit). I also think of the trauma - physical, mental and emotional of open heart surgery is a part of this. I’d known that the valve would have to be replaced since I was a small child, but at the age of 45 I was still not prepared for it.
Waiting for my brain to catch up and the pain in my sternum to subside, happy to be alive.
Best wishes to all,
Deb