Document Detail

Sex, aging, and preexisting cerebral ischemic disease in patients with aortic stenosis.
MedLine Citation:
PMID:  20868818     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Patients undergoing cardiac surgery have a high frequency of preexisting cerebral ischemic lesions, the presence of which appears to predict cognitive sequelae. Patients undergoing aortic valve replacement for aortic stenosis (AS) incur an exceptionally high risk for perioperative cerebral ischemia. The extreme risk in this subgroup may arise from the preexisting burden of cerebral ischemic disease. We tested the hypotheses that increasing age, female sex, coronary artery disease, and the severity of AS are predictive of the severity of preexisting cerebral ischemic lesions.
METHODS: A total of 95 subjects were included in this study. Subjects were imaged on 1.5 Tesla magnetic resonance imaging scanners to obtain multimodal image sets which were used for the automatic segmentation of cerebral lesion volume. The dependence of lesion volume upon age, sex, coronary artery disease, and the severity of AS were tested.
RESULTS: The results demonstrate a strong correlation between aging, female sex, and white matter and ischemia-like lesion volume in patients with aortic stenosis.
CONCLUSIONS: Women and those of advanced age presenting for aortic valve replacement for AS may incur a particularly high risk for postoperative neurologic sequelae due to an exceptional preexisting burden of cerebral ischemic disease.
Ping Wang; Michael A Acker; Michel Bilello; Elias R Melhem; Elizabeth Stambrook; Sarah J Ratcliffe; Thomas F Floyd;
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  90     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-27     Completed Date:  2010-10-21     Revised Date:  2014-09-18    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1230-5     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
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MeSH Terms
Age Factors
Aged, 80 and over
Aortic Valve Stenosis / epidemiology*,  surgery*
Brain Ischemia / diagnosis,  epidemiology*,  etiology
Cognition Disorders / etiology*
Heart Valve Prosthesis Implantation / adverse effects*
Magnetic Resonance Imaging
Risk Assessment
Risk Factors
Severity of Illness Index
Sex Factors
Grant Support
Michael A Acker / ; Joseph E Bavaria / ; Thomas F Floyd / ; Tania Giovanetti / ; W Clark Hargrove / ; Scott E Kasner / ; William H Matthai / ; Elias R Melhem / ; Emile R Mohler / ; Rohinton J Morris / ; Alberto A Pochettino / ; Catherine E C Price / ; Sarah J Ratcliffe / ; Ola A Selnes / ; Wilson Y Szeto / ; Y Joseph Woo / ; Susan E Wiegers / ; Nimesh D Desai / ; Martin G Keane /
Comment In:
Ann Thorac Surg. 2010 Oct;90(4):1235-6   [PMID:  20868819 ]

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