and their individuals surgeons performed within an acceptable range. The results are available on the Care Quality Commission website. Another important source of complications are the neuropsychological and psychopathologic changes following open-heart surgery. One example is Skumin syndrome, described by Victor Skumin in 1978, which is a "cardioprosthetic psychopathological syndrome" associated with mechanical heart valve implants and characterized by irrational fear, anxiety, depression, sleep disorder, and weakness. Risk reduction Pharmacological and non-pharmacological prevention approaches may reduce the risk of atrial fibrillation after an operation and reduce the length of hospital stays, however there is no evidence that this improves mortality. Non-pharmacologic approaches Preoperative physical therapy may reduce postoperative pulmonary complications, such as pneumonia and atelectasis, in patients undergoing elective cardiac surgery and may decrease the length of hospital stay by more than three days on average. There is evidence that quitting smoking at least four weeks before surgery may reduce the risk of postoperative complications. Pharmacological approaches Beta-blocking medication is sometimes prescribed during cardiac surgery. There is some low certainty evidence that this perioperative blockade of beta-adrenergic receptors may reduce the incidence of atrial fibrillation and ventricular arrhythmias in patients undergoing cardiac surgery. See also Frank Gerbode (surgeon) References Further reading External links Surgery Surgical specialties