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Titolo:
Stroke during coronary bypass surgery: principal role of cerebral macroemboli
Autore:
Borger, MA; Ivanov, J; Weisel, RD; Rao, V; Peniston, CM;
Indirizzi:
Univ Toronto, Toronto Gen Hosp, Univ Hlth Network, Div Cardiovasc Surg, Toronto, ON M5G 2C4, Canada Univ Toronto Toronto ON Canada M5G 2C4 Surg, Toronto, ON M5G 2C4, Canada Univ Toronto, Toronto Gen Hosp, Dept Surg, Toronto, ON M5G 2C4, Canada Univ Toronto Toronto ON Canada M5G 2C4 Surg, Toronto, ON M5G 2C4, Canada
Titolo Testata:
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
fascicolo: 5, volume: 19, anno: 2001,
pagine: 627 - 632
SICI:
1010-7940(200105)19:5<627:SDCBSP>2.0.ZU;2-9
Fonte:
ISI
Lingua:
ENG
Soggetto:
ARTERY BYPASS; ASCENDING AORTA; CARDIAC-SURGERY; RISK-FACTORS; EMBOLI; MORBIDITY; OPERATIONS;
Keywords:
stroke; coronary bypass surgery; cardiopulmonary bypass; aortic atherosclerosis; emboli;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
25
Recensione:
Indirizzi per estratti:
Indirizzo: Peniston, CM Univ Toronto, Toronto Gen Hosp, Univ Hlth Network, Div Cardiovasc Surg, 100 Coll St, Toronto, ON M5G 2C4, Canada Univ Toronto 100 Coll St Toronto ON Canada M5G 2C4 C4, Canada
Citazione:
M.A. Borger et al., "Stroke during coronary bypass surgery: principal role of cerebral macroemboli", EUR J CAR-T, 19(5), 2001, pp. 627-632

Abstract

Objective: The purpose of this study was to gain insight into the etiologyof stroke during coronary bypass surgery. Methods: Retrospective review ofprospectively gathered data on 6682 consecutive coronary bypass patients. Patients undergoing simultaneous procedures, including carotid endarterectomy, were excluded. We performed a systematic chart review of all patients who suffered a perioperative stroke. Predictors of stroke were determined with stepwise logistic regression analysis. Results: The prevalence of strokewas 1.5% (n = 98). Stroke patients had significantly increased intensive care unit and hospital length of stays, as well as increased mortality when compared to patients without stroke (all P < 0.001). Independent predictorsof stroke were (in decreasing order of magnitude): age > 70 years, left ventricular ejection fraction < 40%, previous stroke or transient ischemic attack, normothermic cardiopulmonary bypass, diabetes, and peripheral vascular disease. Chart review revealed that the probable cause of stroke was macroemboli, likely from ascending aorta atherosclerosis, in 37% of patients and unknown in 38% of patients. Computerized tomography (CT) scans were obtained in 79 patients (81%). Lesions detected by CT were consistent with a macroembolic etiology: nearly all lesions were ischemic in nature and located in the distribution of major cerebral arteries, particularly the middle cerebral artery. Conclusions: Stroke is a devastating complication of coronarybypass surgery. Our multivariable risk factors for stroke, chart review, and CT findings all suggest that macroemboli, presumably from the ascending aorta, are the predominant cause of stroke during coronary bypass surgery. Future studies should be directed at minimizing the risk of embolization during cardiac surgery. (C) 2001 Elsevier Science B.V. All rights reserved.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 19/01/20 alle ore 14:30:44