Neurological monitoring and off-pump surgery in a very high-risk stroke patient.
Stroke remains a high risk of coronary artery bypass grafting. We present a patient with progressively symptomatic coronary disease and severe four-vessel cerebrovascular disease not amenable to revascularization. This patient underwent coronary revascularization without neurologic complication using off-pump coronary surgery to avoid aortic manipulation and intraoperative electroencephalographic monitoring of cerebral perfusion. This management strategy may reduce the stroke risk in similar patients.
Berry
Mark F
MF
Division of Cardiothoracic Surgery, Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
McGarvey
Michael L
ML
Zeng
Li
L
Woo
Y Joseph
YJ
D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects*; D003943:Diagnostic Techniques, Neurological; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D012307:Risk Factors; D020521:Stroke / Q000209:etiology / Q000517:prevention & control*