Cardiac surgery, carotid stenosis, and stroke prevention.
Stroke following cardiac surgery is a major source of morbidity and mortality. In patients undergoing cardiac surgery, the presence of severe carotid stenosis is associated with a higher incidence of postoperative stroke. Carotid revascularization procedures, such as carotid endarterectomy and stenting, are frequently performed under such circumstances in an effort to reduce the incidence of stroke. The available literature suggests that most postoperative strokes are not directly related to carotid stenosis. Synchronous carotid revascularization and cardiac surgery renders a higher risk of cardiovascular complications. In this article, we summarize the incidences of postoperative stroke and carotid stenosis in this population, discuss the pathogenesis of stroke in these patients, and propose strategies for managing patients undergoing cardiac surgery with severe carotid stenosis.
Li
Yuebing
Y
Division of Neurology, Lehigh Valley Health Network, Allentown, PA 18103, USA.
Jenny
Donna
D
Castaldo
John
J
D000359:Aftercare / Q000379:methods; D000465:Algorithms; D000925:Anticoagulants / Q000627:therapeutic use; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000379:methods; D016893:Carotid Stenosis / Q000150:complications / Q000453:epidemiology / Q000601:surgery*; D015897:Comorbidity; D047549:Coronary Artery Bypass, Off-Pump; D003663:Decision Trees; D016894:Endarterectomy, Carotid / Q000379:methods; D006331:Heart Diseases / Q000150:complications / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007430:Intraoperative Care / Q000379:methods; D018579:Patient Selection; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011182:Postoperative Care / Q000379:methods; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D020521:Stroke / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*
D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors