Post open heart surgery cognitive impairment

This is a real concern with open heart surgery. You need to find a surgeon that will use retrograde perfusion; this keeps blood flowing to your brain during surgery and the risks of cognitive impairment are far less.
Even in the same practice, not all surgeons know how to do this. We believe that it is very very important to do this.
Go to pubmed and search for articles on "cerebral perfusion in aortic aneurysm surgery." This will provide you with a list of surgeons that use this technique and also will provide information on questions to ask.
I asked one of my earlier husband's potential surgeons "what happens if you don't get the repair done in the planned 20 minute cooling timefrane." He had no answer. He laughed actually. We looked for (and found) another surgeon although this guy had a great reputation.

That’s very helpful feedback .. thanks!…

I did go to punned but couldn’t find a link to search for a surgeon who does retrograde cerebral perfusion in… Do you st have that link?
Thanks!

Immediately post surgery I had delirium and my whole body was a wreck. I believe that for about 6 to 12 months I had post perfusion syndrome or "pump head", a feeling of dizziness and forgetting. It wore off at around 12 months. Forgetting the start of a sentence i had just started. Not walking in straight lines. A feeling of being pulled down when trying to walk which is not physical.
Frustration, anxiety, feelings of alienation.
Anaesthetists say that worry and anxiety before surgery can affect the recovery of a patient.
Mine was an emergent surgery with no warning. Please read my story elsewhere.
The surgeon says he told me i had significant risks. Percentages of adverse outcomes. But I know he didn't.
And if he had told me i would have worried so much. So good that he didn't.

Look for articles that discuss cerebral perfusion in aortic aneurysm or aortic arch surgery. People that author these articles probably do it.
Please let me know.

There are many many articles on cerebral perfusion in aortic aneurysm surgery. You need to click on the article to see the authors; then click on the authors to see where they come from. Look at more recent articles. I saw recent articles from the Universities of Colorado, Texas, Ohio, NEw York areas, etc..
There is no list of surgeons and there are issues associated with many aspects of open heart surgery, including cooling the body, etc.. We think it is important to read as many articles as possible; some are easier to read than others but the more you read, the better decisions you will make.

This is a very insightful post . Something I will definitaly keep in mind should I need surgery. I was diagnosed with a 4.4 assending and a 4.2 dessending thoracic aortic aneurysm while getting a calcium scan 2 month ago . I am a 61 yo female. I work in the entertainment (film) industry and my job can be very stressful at times. This whole revelation has put me into a tail spin tbh. and it makes me want to retire soon because I feel 'life is too short" not to have fun. I am so grateful for this support group because I am learning so much about this and most of all, I am not alone!!
I have read that the operation is more risky for females than males , is that something someone can explain or elaborate ?

Finding out you have two thoracic aortic aneurysms is a lot to process—especially when it comes out of the blue during a scan you weren’t expecting much from. That kind of news can shake your whole sense of direction. It’s no surprise it’s made you think about retiring or reevaluating what matters most. Stress really does feel different after something like this, doesn’t it?

You’re absolutely right to be thinking about how your job and lifestyle fit into this new reality. Even if your aneurysms aren’t at surgical size yet, stress and blood pressure still matter. And just having the knowledge puts you in a position to make smarter, more protective choices. That’s a big deal. That said, I am a trial lawyer in federal court. I have managed a good life for the past 10 years after dissection. It can be done but you have to take your meds, listen to your docs, and deliberately relax.

As for your question about surgery being riskier for women—I’ve read the same, and from what I understand, it can be due to a mix of things: women sometimes get diagnosed later, or have smaller vessels, or different symptoms that don’t always get recognized quickly. But that doesn’t mean the outcome has to be worse—it just means you need good doctors who really understand aortic disease and who’ll take your concerns seriously. If your doctor hasn’t given you that kind of confidence yet, it might be worth talking to someone who specializes in this stuff. THINK THORACIC SURGEON.

This group is a lifeline and I’ve learned so much here too. And you’re definitely not alone. I barely survived a fully dissected ascending aorta as a man at 50 in 2015—and looking back, I wish I’d had this kind of support earlier. Peace.

How very kind of you to take the time to reply.
Congratulation to you for having had such a wonderful surgical team. It's actually very good to know that people can survive a dissection. what kind of surgery did you have and did you know that you had an enlarged aorta ?

I have a friend who passed away from a raptured aorta 2 years ago at 60 years old , he literally died in the hospital while the medical team was trying to figure out what was wrong with him... he had no idea he had a thoracic aneurysm.

You really hit the nail on the head with everything you said about making life choices.
I also would like to add that women have the additional factor of "menopause" and the struggle with hormones which can cause anxiety which in return rises BP.

Right now I am vacationing in the German alps where I grew up and it's very grounding and good for my soul. I had a zoom with a surgeon from UCLA (my home town is Los Angeles) but tbh ..I didn't really like their demeanor and nonchalant attitude. Perhaps it's the difference between a physician and a surgeon? I don't know ...I have never had surgery so I don't know if that's just how they are or talk?
I researched the "best" surgeons for this kind of surgery and it seems that they are all in the east . Either Rochester, Minnesota, or the Cleveland Clinic. I have found 2 Surgeons that specialize in this kind of surgery that I would like to know more about.

I am so very grateful to have found this support group
and especially this thread about the possibility of "cognitive impairment" post surgery.

I hope that I will live through this to help others with their discomfort and worries.

Keep looking, not all surgeons have an attitude. I had my surgery to repair a 5.2cm ascending aneurysm 5 years ago, and my surgeon was the nicest person ever, my wife just loved him, he took his time to answer any questions, explained everything in detail, beside the fact that he is one of the best (if not the best) in Houston, TX my hometown.

Reading all the original comments above I did not experience any of those symptoms, mine were mainly physical, the pain of having had my chest open and feeling physically just awful at times, my surgeon told me , I manhandled organs that are not supposed to be touched so it is normal for the body to feel that trauma. Besides that I had no other issues, I was out of the hospital in 5 days, back to work in 3 weeks.

My recommendation is to keep yourself in the best shape possible, treat your body well, exercise (but listen to the weight and exercise limits)

And keep looking, find the best surgeon, someone who has done this hundreds of times, but spends time listening to your concerns, and a cardiologist who is an aortic disease expert, not all of them are. The cardiologist will continue seeing you for the rest of your life so find the best you can.

All the best

Q. what kind of surgery did you have and did you know that you had an enlarged aorta ?

A. I had my ascending aorta graph with the 13 inch Dacron graft 30 mm in diameter.
I had absolutely no idea that I had an enlarged aorta because I had never been scanned for that and it dissected suddenly and without any warning.
I'm sorry to hear about your friend. I can assure you that it was quick.

Q. I had a zoom with a surgeon from UCLA (my home town is Los Angeles) but tbh ..I didn't really like their demeanor and nonchalant attitude. Perhaps it's the difference between a physician and a surgeon? I don't know ...I have never had surgery so I don't know if that's just how they are or talk?

A. Anybody who treats an enlarged aorta with an aneurysm and a nonchalant fashion is unqualified to treat you. An aortic dissection is the single most lethal and the single most complicated surgery to repair in human body. Someone who is nonchalant about it is someone who's ignorant about it. The only person I would trust more than my thoracic surgeon to tell me about the dangers of an aortic dissection would be me, because I had one.

Q. I researched the "best" surgeons for this kind of surgery and it seems that they are all in the east . Either Rochester, Minnesota, or the Cleveland Clinic. I have found 2 Surgeons that specialize in this kind of surgery that I would like to know more about.

A. I would recommend Dr. Lyle Joyce who is I believe in Milwaukee now. He was the chief of thoracic surgery at Mayo for a time but now he is over in Wisconsin. I would recommend my surgeon at UCSD La Jolla in San Diego, but he's retired now.

Q. I am so very grateful to have found this support group and especially this thread about the possibility of "cognitive impairment" post surgery.

A. Look, any open-heart surgery is going to mess with your head at some level. After having open-heart surgery, I picked myself up and went to Omaha for a federal mediation 42 days after I had surgery. I'm not gonna lie to you that I was a mess and my wife was very fearful that I would be traveling, but I felt that I needed to pick myself up and dust myself off and start all over again. I did. And now almost 10 years later I am still here, and I am still rebuilding and healing in the sense that you never really get past the experience, but you can help yourself move through it by helping others. As for my cognitive impairment? I'm gonna let you be the judge of that.

Q. I hope that I will live through this to help others with their discomfort and worries.

A. You will. Peace. Here's me three weeks ago standing with my favorite federal judge--you survive, you live on, you thrive....