[Clinical results of open heart surgery within 2 weeks after cardiogenic embolic stroke].
Fourteen patients, 5 with infective valvular disease (IVD), 7 with non-infective valvular disease (NVD) and 3 with LA myxoma, underwent open heart surgery within 2 weeks after cardiogenic embolic stroke because of uncontrolled heart failure or recurrent embolism. Fifty percent of patients experienced a second embolism within 2 weeks of the initial stroke. Preoperative brain CT revealed no hemorrhagic infarction in all patients. However, in 3 of 5 patients with IVD, who had large brain infarction, one patient died from massive brain edema and two patients from severe brain hemorrhage. The other 2 patients with IVD, who had small infarction, and the remaining 7 patients with NVD and LA myxoma, even having large or small infarction, recovered without any complications. From these results, we concluded that 1) Open heart surgery within 2 weeks after initial stroke was safe in patients with no brain infarction and small non-hemorrhagic infarction, 2) Patients with IVD should be treated surgically before embolic stroke, because mortality rate was so high even in patients with non-hemorrhagic infarction.
Masuda
T
T
Department of Cardiovascular Surgery, National Cardiovascular Center, Osaka, Japan.
Kawazoe
K
K
Kosakai
Y
Y
Ohara
K
K
Kitoh
Y
Y
Fujita
T
T
D000328:Adult; D000368:Aged; D000785:Aneurysm, Infected / Q000601:surgery; D004630:Emergencies; D005260:Female; D006349:Heart Valve Diseases / Q000150:complications / Q000601:surgery*; D006350:Heart Valve Prosthesis; D006801:Humans; D002542:Intracranial Embolism and Thrombosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D013997:Time Factors