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“How Long Will My Dad’s Pumphead Last After Heart Valve Surgery?” Asks Rob

Posted on August 4th, 2009 under Patient Stories & Updates.

I just received a follow-up question from Rob about pumphead and memory loss after heart surgery that you might find interesting.

Rob writes, “Hi Adam – I have a quick question. My dad just had open heart surgery two days ago to repair his mitral valve (it was a 4+ for regurgitation). He also has had previous issues with atrial fib. Today, he was having some issues remembering particular words/phrases. This concerns the nurses and us because of the possibility of brain issues after surgeries like these. I have a doctor-friend who says some of this is normal based on all the drugs he is on and the use of the heart-lung machine. Did you experience any of the brain and thought issues with your surgery? Do you have any insight on that? Thanks so much, Rob”

Although I did not have any direct cognitive problems following heart surgery, I have written about this post-operative complication on several occasions.

To help Rob, I offered him a link to a recent blog about pumphead and memory loss after bypass surgery.

After reviewing that page, Rob had one more question. He wrote back to me, “One thing not covered in your pumphead discussion is how long the ailment lasts? Any thoughts? Obviously, everyone is anxious to get the patient “back to his normal self”, but we all forget how long the process can truly take. So I hope we’re not just jumping the gun on all this.”

Again, Rob raises another great question. Unfortunately, I have not read many clinical studies about the length of time for which “pumphead” may exist as a post-operative complication for bypass patients. However, in 2001, researchers at Duke University conducted a study of 261 patients which was published in The New England Medical Journal.

Following bypass surgery, the patients were tested for their cognitive capacity (i.e. mental ability) at four different times: before surgery, six weeks, six months, and five years after bypass surgery. Patients were deemed to have significant impairment if they had a 20% decrease in test scores.

This study had four major findings:

Cognitive impairment can occur after bypass surgery.
The incidence of cognitive impairment was greater than most doctors would have predicted. In this study, 42% of patients had at least a 20% drop in test scores after surgery.
The mental impairment was not due to the patients’ age (which averaged 61).
The impairment was not temporary, as many doctors have claimed (or at least hoped). The decrease in cognitive capacity persisted for 5 years in some patients.

The results from the Duke study were compared to results from a similar study among patients of the same age who did not have bypass surgery, according to Richard N. Fogoros, M.D. The decline in mental capacity in those patients who had bypass surgery was 2-to-3 times higher over five years than in patients who did not have surgery.

The Heart Lung Machine

In review of this study, a sense of alarm may come over you. Please note, this study was performed eight years ago and there has been some debate over whether (or not) the heart-lung machine is the source of cognitive decline following bypass surgery.

Regardless… This is one more reason why you really need to conduct proper diligence and research prior to surgery. In my humble opinion, this potential risk is why so many patients search for the most skilled surgeons to perform their heart valve surgeries… to minimize their time on the “pump”.

Did you experience any form of cognitive issues after bypass surgery? If so, what was your experience? Please click here to leave your comments. (Or, scroll down to read 15+ patients comments on this topic.)

Keep on tickin!

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Midge says on August 4th, 2009 at 10:44 pm

Yes, I definitely experienced pumphead. I’m 67 and had an aortic valve replaced in Feb. ’09…puts me at just about six months. Somewhere I have records of the length of time I was on the bypass machine and will look it up later. First, I have no memory from the time I left the post-op area on Friday AM until sometime on Monday afternoon. At first I was freaked about having lost 3 days of my life but then realized I did not have to experience the throat tube, all the wires, etc. that come with the first few hours after surgery. That’s a plus!

When I finally did come around, I was in the step-down stage and in my room with my roommate, which I though was great because we were able to talk back and forth about what we were feeling, questions that neither of us could answer, etc. So I’m one of those people who enjoyed having a roommate. Anyway, I also had some wild hallucinations during those first three days, but they passed pretty quickly; however, they were definitely frightening at times.

Back to pumphead…my roommate and I laughed our heads off alot of times because we would be talking and just couldn’t find the word we wanted to use. It’s very frustrating until we realized we were both experiencing it and began to see the humor in it. We said alot of, “oh, you know what I means”. Nurses blamed alot of it on the amount of drugs in our system from surgery and those that are continued to be added after surgery.

It has lessened alot over time and I don’t notice it much by this time except in spelling. I have been an excellent speller all my life and now find I must use a dictionary more often to make sure my spelling is correct. However, we own our own small manufacturing business and I have had no trouble getting back into running it, phones, employees, etc. But, yes, there are still some minor affects.

I wouldn’t worry about him at this point and just make it a fun thing…that’s what helped me the most. At this point your body has gone thru so much trauma that I can say, as a patient, I was a whole lot more concerned about my body than my mind. It may take months and months for him to come back to what you feel is adequate, but just give him the time and help he needs. My husband still has to correct me often because we have a “Ram” truck and a van and I am constantly saying one when I mean the other.

Just be happy he’s going to be with you alot longer because of this surgery.

Midge

Laura says on August 5th, 2009 at 1:36 pm

Hi Rob. I agree with a lot of what Midge wrote. For me, it took at least 6 months till I felt that my brain was not foggy.
I think it’s a question of time. As the body heals, I’d figure the mind is healing too. ( What did I just write??…Only kidding! )
Good luck and hope your dad is feeling better and better every day!
Laura

debbie Berman says on August 5th, 2009 at 1:46 pm

I had a mitral valve repair in December 20008. I was a little confused for a few days, but that quickly cleared up. However, it took until May to feel like my head and body were connected. It seemed like one day I felt very spacey and the next day it was all gone. I haven’t had any problems since and it is now 7 months post surgery. I wish your dad well and hopefully after a period of time he will be back to himself. Debbie Berman

Sean R says on August 5th, 2009 at 1:53 pm

I am now 11 months post-op. I saw my cardiologist yesterday and told him I’m disappointed that I still have some pump-head effects. He was not surprised and said “pump head is real”. The effects have very gradually lessened over these 11 months. It’s just a nuisance – and an embarrassment when I can’t remember an acquaintance’s name. (Names – of people and objects – are my main problem; of course, I wasn’t so good with names before surgery, either!) Mine is pretty mild – not bad enough to prevent me from earning A’s in a new undergraduate program I’ve started at a local university – at age 61. My cardiologist mentioned something about “off-pump procedures”, so that may be something to investigate for anyone anticipating surgery. I don’t know anything about it, and it may not even be possible for valve replacement surgery – but something to look into.

Kemal says on August 5th, 2009 at 3:52 pm

Yes, I do have some issues remembering particular words/phrases, forgetting directions I knew very well before, going to wrong conf. rooms for meetings, using wrong names for people, etc. I don’t know how much it was related to headpump
machine, but I also had two mini strokes one about 10 days after the mitral valve replacement surgery, the other one 4+ months after the surgery.

Kemal

Doug Callison says on August 5th, 2009 at 4:58 pm

Am a 69 year old retired chemical engineer who had aorta (tissue) valve replaced, 3 by passes, double ablation in January ’09 which meant a longer time on the machine – and I was very concerned about pump head. Had very severe complications (congestive heart failure resulting in acute renal failure) after returning home from the surgery – back to hopital for 16 days, but no problem whatsoever with depression or brain function. I am fully recovered and feel great after finishing rehab (more energy than I had 20 years ago!)

Richard Holoubek says on August 5th, 2009 at 8:01 pm

I had my aortic vavle replaced 2/25/09. I did not experience pumphead, but when my wife gets on me about not remebering what she told me… I blame it on pumphead… the secret is out!

Adam Pick says on August 6th, 2009 at 1:36 am

All,

Thanks for sharing!

To Richard,

Thanks for sharing your secret.

Adam

Charlene says on August 6th, 2009 at 7:00 am

I also had pumphead. I am close to my anniversary Sept. 10 and occasionally I will have trouble remembering things or will be talking and lose my train of thought. But it is a great deal better than when I first had the surgery. I had aorta replacement as well as aortic valve repair, I was one bypass for a long time, plus had all brain function stopped to replace the arch. I knew going into it that doing all of that would have to affect me in some way. The alternative was that I would not be here… The way I looked at it is that a little mental issues compared to the alternative ……. I will take the mental issues every day. They did put me on Plavix and that did help. All I know is that I am happy to be here and feel like I have been given a second chance at life!

Gail says on August 6th, 2009 at 7:17 am

My husband had aortic valve replacement last september. I think he still has some pumphead. He will occasionally ask the same question several times. We call him pumphead when he does this.

Midge says on August 6th, 2009 at 7:46 pm

I agree with Richard….pumphead is a great excuse (as long as you don’t use it too often). Also agree with Charlene, a little forgotten memory is a small price to pay for a continuing and more productive life. The greatest way to deal with it is to laugh about it, make jokes about it with those around you and warn people that need to know that it can happen so if they think you said something wrong, they should question you about it. Once I was able to go back to work and was supervising a number of employees directly, I told them all that it probably would occur from time to time, there was nothing I could do about it and to ask questions if something I said didn’t ring true. It works and keeps things going in the right direction. The same could be said for the family units we all live within.

Enjoy! Midge

Maureen says on August 9th, 2009 at 10:44 pm

I am 10 months post aortic valve replacement. I felt completly unable to focus concentration on reading, conversation or thought for several weeks after surgery. I also had some “down days “for a few weeks after surgery. All seemed fine after 7 or 8 weeks. I was 56 years old at the timeof my valve replacement. I am sure as with all aspects of surery, age plays a factor in the speed of recovery.

James Hoard says on August 11th, 2009 at 12:55 am

Hello All:

I spent eleven days at the Brigham and Woman’s Hospital in Boston in March, 2008. I was on the operating table for five and one half hours for tricuspid and mitral valve repair, a single bypass utilizing a chest graft and a maze procedure to reroute the electrical impulses in my sinue node. I suffered terribly from atrial fibrilation both before and after the surgery.

I’m sixty-one years old and always had a good memory. Since the surgery I have noticed short term memory loss, mostly instant recall of words or phrases from time to time. Also, a serious inability to concentrate for about six weeks after my surgery. I intentionally purchased about five books and planned to read them while on a two month leave of absence from work. I read none. Also, I went through a severe bout of depression which last for a little over a month. The pumphead effects are dissipating, but very, very, slowly. Also, my sternum separation is healing, but also very slowly. My chest binds, there is pain, and there is constant numbness.
The comment made by a previous comment poster about a cut peritoniutm is true. My heart still pounds and pops even after a cardioversion treatment returned my to normal sinus rhythum.

patrick tighe says on August 12th, 2009 at 12:07 am

I had mitral valve replacement 14 months ago. I spent a month in ICU during which time the valve failed completly. I have short term memory loss still today. I also suffered a mini stroke on the table or after that effected my left arm and leg. Leg and arm work fine today.
I have to write down all important messages right away otherwise there is a good chance that I will forget the message. The main thing that I have found is that all family and friends have been told not to give me messages to pass along. It is working very well. I just take it all in and just very thankful to still be here today. I hope that helps a little.

Marianne says on August 14th, 2009 at 8:15 am

I had aortic valve replacement in 2003. After my surgery I felt better than I had in years. Stronger physically with more endurance. But had problems with my memory and cognitive skills for about a year after the surgery. Now 6 years after the surgery, my mental skills are becoming worse. I cannot keep things in order, especially papers. I have short term memory loss, and cloudy thinking. I am in risk of losing my job as a nurse. I especially have problems with the computer. Can’t remember what I did or did not chart on the computer.
Marianne

Lisa says on August 14th, 2009 at 1:58 pm

Marianne, I am also a nurse and only a few months out from my mitral valve surgery. I had worked in the ER and found I could not physically or mentally handle it when I returned and transferred to a case management position. The nice thing about nursing is that there are a lot of different opportunities. As much as I miss the ER, I am still glad to be employed. I wish you luck.

Cornel says on August 17th, 2009 at 8:53 am

I wish I knew about this book pre-op. I am now 16 months post-op after I had my Mitral Valve repaired. I was 32 when I had the surgery. I can not remember feeling “phased out” or “pumphead” – maybe I am to young for it dunno

I had a lot of pain and lived on sleeping pills and meds for a while and was off-work for 4 months… maybe that helped?

Geoff says on April 11th, 2010 at 4:33 pm

Well, this is more ammunition for putting off my aortic valve replacement as long as possible. I run a financial system for a major pharma company, and I’m responsible for about $1.6 billion of inventory costs. I wouldn’t want pumphead affecting me on the job! My valve replacement procedure looks pretty straightforward, but who knows what might crop up?

Barbara says on July 13th, 2010 at 3:32 pm

My 85-year-old mother had aortic valve replacement in January and went home 8 days later. After one day in skilled care she was sent to the local hospital for a couple of days, then airlifted back to UVa Medical Center (where she had the original surgery) in very bad condition, very gray and suffering from tamponade. A second open-chest procedure was performed. After that she was in ICU for 6 weeks, on a ventilator. She spent an additional 3 weeks at a long-term care hospital to get off the vent and another 8 weeks in a skilled care facility. She finally made it home after five months, but is having quite a time with short-term memory loss. She used to do crosswords all the time, but can’t manage even a couple of words now. We wonder if she’ll ever be back to “normal” and now wish she hadn’t had the original replacement.

Ricki says on July 13th, 2010 at 4:27 pm

I had the opposite experience! I had AVR in May. Prior to the surgery, for more than a year, I had memory and cognitive issues. My cardiologist said it was because my brain was not getting enough oxygen.

Since my surgery I’ve been much better. I still have some lapses . . . not finding the right word and such, but I don’t feel foggy-headed anymore.

Bill says on September 27th, 2010 at 9:07 am

I had quadruple bypass surgery preformed in July. For about 30 days post-op, I felt like I was in a fog…Thank God that passed. However, I find myself constantly grasping for words, especially when I am speaking. Oddly, that does not seem to happen when I am typing or writing.
I am a 53 year old health care professional. I am not worried that my clinical judgement it off, I’ve done a lot of CME tests on-line and seem to have no impairment in that respect. However, I am constantly required to give verbal patient assessments and updates.
I am terrified that I am going to be spitting and sputtering like an old car.

Randy johnson says on October 24th, 2010 at 8:39 pm

Several things have occured after a mitral valve repair. A loss of creative writing skills and it takes concentrated effort to make journal entries. I’ve noticed a reduction in the ability to multitask and it has been difficult to learn new skills. I found that I have less tolerance of people than before the surgery and that I’m quick to verbably retaliate. I’m on my second pacemaker now. The surgery was in late 1999. Then again, maybe I’m just getting older.

Michelle says on November 21st, 2010 at 11:48 pm

Dear Adam,
So glad I found this blog. My mother had an aortic valve replacement and triple by-pass in July. She was a vivacious, busy, 85 year old, who mowed her own lawn, ran her church group, and kept up with her 7 kids and 22 grandchildren. Sadly she is not the same person now. My father died of Alzheimer’s disease, and tragically she almost seems to be showing similar symptoms to his onset. She can no longer get her own meals- last Thanksgiving she cooked for the whole family. She was an avid cross-word solver and enjoyed reading the paper, now she doesn’t even open the first page. We are at a loss of what to do. She has been a hard working dairy farmer, homemaker, friend, and a wonderful mother, and we just don’t know what to do for her.

We have tried everything the doctors have told us to do, and we are obviously seeing to her daily needs, but it is just so heartbreaking. I realize that at her age some of this could be expected, but it’s not her, she has always been so independent. She is currently on anti-depressents, but we think there has to be more to it than that. She has an MRI on her brain scheduled next week. Any advice would be appreciated.

Don Walls says on April 11th, 2011 at 12:32 am

I had mitral valve repair and double maze procedure 1/26/2011. I have had the trouble getting words out. Also some times saying the words in the wrong order. And trouble understanding what people are saying. Some of this could be called aphasia I think. At 10 weeks now and most of that has faded.

emily says on August 12th, 2011 at 2:01 pm

Wow, such interesting stories that I can somewhat relate to. I had open heart surgery 15 months ago and my short term memory was absolutley effected. I am constantly having to grasp for peoples names and the names of places. It always eventually comes to me, but it takes a little while. so frustrating because I am only 36 years old. I am uncertain if I was on bypass during surgery, but I believe so. Has any one had any positive results with any natural memory enhacers?! ginko…DHA?

Colleen says on August 17th, 2011 at 11:23 am

I had open heart surgery 18 months ago. I was on bypass for some time. I had an aneursym in my aortic root and they replaced my aortic root with a dacron graft. I was 47 at the time. I am a Surgical Technician. I have noticed a decrease in my cognitive thinking. Since the surgery I have had issues at work with remembering instruments during surgeries, as well as, everday tasks. I started to do research on the subject and came across your articles on “Pump Head”. It sounds all too familiar. It is really impairing my work. Can this be considered a disability? I would appreciate it if you would email me about this subject and help me find more information. Thank you. cbbcd@aol.com

James Pellechi says on September 8th, 2011 at 7:02 pm

Had Ascending Aorta aneuyrism repaired in March 2007 … Have experienced deminishing mental abilities since. I stumble frequently to remember peoples names – including my employees who have worked years with me? It often takes an external ‘trigger’ to assist me in remembering, rarely am I remembering on my own …

Had Aortic Valve replacement in June 2011. I’ve just returned to work, some 10 weeks later and experienced something that has never happened before … I had absolutely no recollection of ever meeting my Boss’s boss? … This isn’t just a temporary loss of memory – this is actually a memory ‘wipe’.

It’s very disturbing to realize your now mentally different … and no short term solution anywhere on the horizon … The instinct is to ‘run’ from whatever it is you do in life … and find something ‘new’ to do … if your fortunate enought to afford such a change in life …

Kathleen says on September 24th, 2011 at 8:42 pm

I believe I am a ‘pumphead’ following my aortic valve and root replacement three years ago. I came to your site for persistent pain in the sternum, but I was wondering whether anyone else had experienced a form of aphasia since the surgery. I can visualize a word, describe the number of vowels, the number of letters in the word, and such but I cannot say the word. Sometimes I feel that a conversation with me must be like playing Wheel of Fortune. I had nothing like this prior to the surgery. I also feel that my mental acuity has been affected. I feel fortunate to have had above average intelligence that allows me to function normally, even with the loss.

chantal cermak says on October 17th, 2011 at 12:04 am

I have suffered from memory loss and am slowly coming back. I used to do word scrambles and at first was confused post surgery but am able to do them again. I don’t have good short term memory at all. I have long term and now. I cannot remember people but do know that I know them. I explain to people and sure enough I have known them. I’m very tired. I had an Ascending Aortic Aneurysm repaired before dissection at the Cleveland Clinic. I now have leaky valves which I never had before but they say it’s just weakness in my heart showing up after the aneurysm was corrected. Once you correct one thing, other things show up. I have lack of ambition. It seems like a ton of work mentally. My spirit is ambitious but I’m tired. I’m an Olympian 1994. Driven, focused and capable. Now the simple things in life are what I do. I don’t know though, how can a person be angry if it let you raise your kids and kept you from dying. It is getting better though.

Frank Marocco says on November 5th, 2011 at 11:38 am

I am a little over year post surgery. Short term memory seems to be getting worse. Starting to get concerned. My kids are making fun of me, not remembering conversations I have had with them. Anyone have this happen? Thought it was supposed to get better.

Pat says on March 3rd, 2012 at 2:34 am

My mitral valve repair was just four months ago. After reading most of the comments here, I was somewhat comforted as well as somewhat frightened. I have a tremendous loss of short term memory. The frustration of my situation often results in periods of severe depression as I don’t trust myself anymore and feel terribly inadequate in so many of the things I try to do. (I have lost two expensive cell phones because I forgot where I put them down.) I’m also terrible at remembering proper names or any pronouns really.

My cousin is a perfusionist (he runs the heart/lung machine during heart surgery)and I plan to pick his brain about all of this. I’m 67 and don’t want to spend the rest of my life in this diminished capacity. I’m hoping that time is the answer.

madeleine says on April 23rd, 2012 at 5:05 pm

I had heart surgery June 2009 for aortic valve replacement.I am now 68 years old and have noticed, since surgery that my memory is not as good as it was i.e. often words and names etc. I can understand it could be down to age, but it was such a noticeable change to myself that I mentioned it to my husband, who had a friend that had the same symptoms after heart surgery. I omitted to say that I do have an inoperable meningioma which has not changed since diagnosis. It appears to be more common than you think.

JimP says on May 16th, 2012 at 5:02 pm

March 2007 – Ascending Aorta Aneuryism repair … memory loss started immediately following … 53 Years old at the time … no-way was the loss related to age …

June 2011 – Aortic Valve replacement …
Additional loss of short-term memory … 2nd operation has made life challenging …

My wife is now using my memory impairment – to her advantage … (kind-of-funny) …

Torn between being thankful I’m alive and dreading the thought that it can deteriate to a level like alzheimer’s disease …

I personally don’t believe Doctor’s have a clue what’s going on …
It’s only because of blogs like this one, that I know I’m not alone …

I need to retire from my Technical job because I’m not up to my own standards … that really stinks …

GaryB says on July 23rd, 2012 at 1:24 pm

9 years after Quad Bypass, was 42 then, major short term memory loss with normal activity recolation. Major events still ok, but day to day, can’t remember what I did day before most of the time. It sucks.

P. Devoy says on March 4th, 2013 at 8:13 pm

ny husband is 4-5 mos post op and has memory problems. E.G. can’t remember his time tables.

In addition he has short term memory problems.

Will this improve over time

Mike Meeker says on March 7th, 2013 at 10:01 pm

Reading through these posts I’m thinking, Heck i never could remember names. I never could remember what I did yesterday. But, I have a fine memory minutia. People ask me .. How do you remember little stuff like that?..

Well, now I’m looking forward to an Aortic Valve job. I’m 71 and just wondering what this “pump-head” stuff is likely to do to me. Theres always good drugs for the pain involved, but the consequences of this Pump-Head stuff looks like a total crap-shoot.

Oh well, Que Sera.Serra as they say…A new adventure in life awaits.

Heidi says on March 8th, 2013 at 7:06 pm

It’s been 1 year since my rushed Mitral Valve repair. I still have the short term memory problems and can no longer go down escalators because of the dizziness, I was only 50 years old when I had my surgery. Since I run my own business it’s been very frustrating but at this point I am learning to adapt with the help of sticky notes and the calculator on my phone!