| Stroke after Coronary
Artery Bypass Grafting |
(Department of Cardiovascular Surgery, Japanese
Red Cross Society, Wakayama Medical Center, Wakayama, Japan)
| Kenji Minakata, |
Yutaka Konishi |
Masahiko Matsumoto |
| Michihito Nonaka |
Narihisa Yamada |
|
|
Risk factors for stroke
after coronary artery bypass grafting (CABG) were assessed. We
retrospectively investigated 681 consecutive patients who underwent
isolated, first-time CABG at our institute between 1987 and 1998.
Ninety-eight patients (14%) had a history of preoperative stroke.
They tended to be older and with a higher incidence of peripheral
vascular disease (PVD) than those without preoperative stroke.
In spite of several techniques for prevention of postoperative
stroke, such as the aortic non-touch technique, 14 patients (2.0%)
suffered postoperative stroke. Postoperative stroke was diagnosed
soon after surgery in 7 patients (50%), and the causes of stroke
in these patients seemed to be intraoperative manipulation of
the ascending aorta in 5, and hypoperfusion during cardiopulmonary
bypass in two. Stroke in the remaining 7 patients occurred after
normal awakening from anesthesia, and the cause was unknown.
We then compared the patients with postoperative stroke (n=14)
to those without postoperative stroke (n=667). Statistical analysis
demonstrated no significant difference between the two groups
in variables such as history of preoperative stroke, duration
of cardiopulmonary bypass, and prevalence of PVD. Four (29%)
of the patients with postoperative stroke died, due mainly to
aspiration pneumonia. The morbidity and mortality of the patients
who suffered postoperative stroke were very high.
Jpn. J. Cardiovasc. Surg. 29: 139-143 (2000) |
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