Preoperative cerebrovascular screening before cardiovascular surgery in a high risk area of cerebrovascular events in Japan.
BACKGROUND
Cerebrovascular disease and cervical artery diseases are potentially treatable conditions that are associated with an increased incidence of stroke after cardiac surgery. This prospective study was designed to determine the prevalence of cerebrovascular diseases in the high risk population of cerebrovascular event including some young patients in Japan and establish the strategy for cardiac surgery of patients with cerebrovascular disease.


METHODS
100 (71 male, 29 female) of 126 consecutive patients undergoing cardiac surgery under cardiopulmonary bypass were screened for the presence of cerebrovascular disease by intra-arterial angiogram.


RESULTS
In seven patients angiographic evaluation disclosed some evidence of cerebrovascular disease for 50% or greater stenosis or cerebral aneurysm. Preoperative 99mTc-Hexamethyl propylene amino oxime (99mTc-HMPAO) single emission computed tomography (SPECT) with combination of balloon arterial occlusion test provided detailed information of cerebral ischemic tolerance and reliable decision making for surgical repair of cerebrovascular disease. No deaths were recorded and a small stroke in one patient.


CONCLUSIONS
We concluded that cerebrovascular screening in patients with cardiovascular disease may be requested in a high risk population of cerebrovascular events.
Department of Cardiovascular Surgery, Aomori General Hospital, Japan.
K
K
Takeuchi
K
K
Maida
S
S
Yoshida
H
H
Midorikawa
H
H
Noda
S
S
Suzuki
S
S
Tanaka
D000328:Adult; D000368:Aged; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D002533:Cerebral Angiography; D002560:Cerebrovascular Circulation; D002561:Cerebrovascular Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D001026:Coronary Artery Bypass / Q000009:adverse effects; D003327:Coronary Disease / Q000601:surgery; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods*; D012189:Retrospective Studies; D015899:Tomography, Emission-Computed, Single-Photon