Risk of cardiac surgery in patients with prior stroke.
We retrospectively examined the clinical outcome in 126 patients with a history of ischemic stroke undergoing open heart surgery (OHS). We classified prior strokes as recent or remote and by degree of neurologic deficit. Seventeen patients (13.4%) had new strokes or worsening of prior deficits, but only 4 were moderate-severe in degree (3.2%). There was no significant difference in new stroke rates between recent and remote stroke groups. New strokes more frequently involved worsening of prior deficits in the recent stroke group, while strokes in different areas of the brain occurred more often in the remote stroke group. Extracranial occlusive disease was not a factor. Intraoperative hypotension was more frequent in the recent stroke group, suggesting persistent hemodynamic vulnerability.
Rorick
M B
MB
Department of Neurology, Cleveland Clinic Foundation, OH 44195.
Furlan
A J
AJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001157:Arterial Occlusive Diseases / Q000150:complications; D002340:Carotid Artery Diseases / Q000150:complications; D002343:Carotid Artery, Internal; D002561:Cerebrovascular Disorders / Q000209:etiology* / Q000503:physiopathology; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed