Stroke after coronary artery bypass grafting in patients with cerebrovascular disease

Citation
T. Hirotani et al., Stroke after coronary artery bypass grafting in patients with cerebrovascular disease, ANN THORAC, 70(5), 2000, pp. 1571-1576
Citations number
17
Categorie Soggetti
Cardiovascular & Respiratory Systems","Medical Research Diagnosis & Treatment
Journal title
ANNALS OF THORACIC SURGERY
ISSN journal
00034975 → ACNP
Volume
70
Issue
5
Year of publication
2000
Pages
1571 - 1576
Database
ISI
SICI code
0003-4975(200011)70:5<1571:SACABG>2.0.ZU;2-8
Abstract
Background. Stroke has been associated with a significantly increased morta lity from coronary artery bypass grafting (CABG). To determine the predicto rs of stroke in patients undergoing CABG, we collected data on 472 consecut ive patients. Methods. From March 1991 to March 1999, all patients undergoing CABG at our institution underwent routine duplex scanning of the extracranial carotid and vertebral arteries. Seven patients with symtomatic carotid stenosis wer e treated by carotid endarterectomy (CEA) before CABG. Results. There was a 10-fold increase in mortality (12.5%) associated with postoperative stroke. Many variables were analyzed by a mutivariate techniq ue and the severity of extracranial carotid artery stenosis was determined to be the only independent predictor of postoperative stroke (p < 0.01). No ne of the patients with carotid artery occlusion and none of the patients w ho underwent CEA before CABG experienced a stroke. Conclusions. To reduce the stroke rate, the indications for prophylactic CE A may be extended for asymptomatic patients with carotid artery stenosis gr eater than 75%. (Ann Thorac Surg 2000;70:1571-6) (C) 2000 by The Society of Thoracic Surgeons.