PUMPHEAD.

'Pumphead' is a term used among surgeons referring to the dimwitted state in which patients seem to linger after being hooked up to a heart-lung machine for open-heart or valve surgery. Symptoms include patchy recall, social difficulties and personality changes. A study of bypass patients indicates that after an initial recovery of mental capabilities in the first few months, the condition often worsens later and persists for years. John Heysham Gibbon Junior of Jefferson Medical College in Pennsylvania performed the first successful human surgery using a heart-lung machine. In 2001 a 'New England Journal of Medicine' article by Mark F. Newman, chair of Duke University Medical Center's department of anesthesiology, and his colleagues revealed that even after five years many coronary-bypass patients still struggled with severe mental impairments. Although the idea is not proved, the heart-lung machine is a suspect in cognitive decline. Although off-pump surgery may not be suitable for every situation, it may be an option for some patients who cannot tolerate the stress of the heart-lung machine. INSETS: Overview/Cognitive Decline;MECHANICAL HEART AND LUNGS.