Psychological effects of invasive cardiac surgery and cardiac transplantation

Abstract

Psychiatric symptoms are common after cardiac surgery, particularly adjustment disorders, major depressive disorder, posttraumatic stress disorder, delirium, and cognitive disorders. Depression has been reported in up to 37 % of patients after coronary artery bypass graft surgery and up to 63 % of patients after cardiac transplantation. PTSD has a prevalence of 15-25 % in postoperative cardiac patients and 10-17 % among posttransplant patients. The reported incidence of delirium among postoperative cardiac patients ranges from 10 % to 50 %. Postsurgical psychopathology confers significant morbidity and mortality. This chapter will review the prevalence, clinical features, and treatment of the most common psychiatric disorders after open-heart surgery (including coronary artery bypass graft and valve repair procedures) and orthotopic heart transplant.