The risk of stroke following CABG: one possible strategy to reduce it?
Int J Cardiol
; 98(2): 261-6, 2005 Feb 15.
Article
em En
| MEDLINE
| ID: mdl-15686776
ABSTRACT
OBJECTIVE:
Stroke remains a devastating complication of coronary artery bypass grafting (CABG) we evaluated whether a more aggressive diagnostic and therapeutic approach can reduce its incidence.METHODS:
Between January 1998 and January 2002, 1388 consecutive patients underwent isolated on pump CABG with blood cardioplegia. Among the first 627 patients (Group A), Echo-Doppler study (DS) was performed only in selected patients (58) with history of cerebrovascular disease (CVD) and/or carotid bruit; in 761 patients (Group B), DS was performed routinely. Carotid endarterectomy (CEA) was performed in 45 patients in Group A associated to CABG during cardiopulmonary bypass (CPB) and in 90 patients in Group B under local anaesthesia before CABG. Brain CT scan was performed in all cases with postoperative neurological symptoms.RESULTS:
The two groups were homogeneous for age, sex, associated diseases, history of CVD, number of graft and CPB time. There were no differences in terms of hospital mortality between Group A (22/627 3.5%) and Group B (21/761 2.75%); p=0.5. Postoperative stroke was observed in 24/627 (3.82%) patients of Group A and in 2/761 (0.26%) of Group B (p<0.001). Hospital mortality for stroke was higher in Group A (12/627 1.91%) than in Group B (0/761; p<0.001) as well as the incidence of non-fatal stroke (Group A 12/627 1.91% versus Group B 2/761 0.26% p=0.006).CONCLUSIONS:
Preoperative DS, performed in all cases of CABG, followed by CEA under local anaesthesia in patients with critical carotid stenosis reduces the incidence of postoperative stroke.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Ponte de Artéria Coronária
/
Estenose das Carótidas
/
Doença das Coronárias
/
Acidente Vascular Cerebral
Tipo de estudo:
Etiology_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Int J Cardiol
Ano de publicação:
2005
Tipo de documento:
Article
País de afiliação:
Itália