| The risk of stroke following CABG: one possible strategy to reduce it? | |
| | |
MedLine Citation:
|
PMID: 15686776 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
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. |
| | |
Authors:
|
M De Feo; A Renzulli; F Onorati; J Marmo; N Galdieri; L S De Santo; A Della Corte; M Cotrufo |
Related Documents
:
|
10835436 - Medical complications after stroke: a multicenter study. 20868216 - Safety and feasibility of intraarterial eptifibatide as a revascularization tool in acu... 22365176 - Optimal conduit choice in the absence of single-segment great saphenous vein for below-... 16548006 - Long-term efficacy of transcatheter patent foramen ovale closure on migraine headache w... 3166576 - Results of facial nerve decompression. 20533106 - Comparison of 7- and 14-day first-line therapies including levofloxacin in patients wit... |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: International journal of cardiology Volume: 98 ISSN: 0167-5273 ISO Abbreviation: Int. J. Cardiol. Publication Date: 2005 Feb |
Date Detail:
|
Created Date: 2005-02-02 Completed Date: 2005-05-26 Revised Date: 2007-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 8200291 Medline TA: Int J Cardiol Country: Ireland |
Other Details:
|
Languages: eng Pagination: 261-6 Citation Subset: IM |
Affiliation:
|
Department of Cardiothoracic Sciences, Division of Cardiac Surgery, Second University of Naples V. Monaldi Hospital, Italy. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Carotid Arteries / ultrasonography Carotid Stenosis / epidemiology*, surgery, ultrasonography Comorbidity Coronary Artery Bypass / adverse effects* Coronary Disease / epidemiology*, surgery Echocardiography, Doppler Endarterectomy, Carotid Female Hospital Mortality Humans Male Middle Aged Stroke / etiology, mortality, prevention & control* Subclavian Artery / ultrasonography Ultrasonography, Doppler |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Characteristics of infective endocarditis in a developing country-clinical profile and outcome in 19...
Next Document: Influence of intensive coronary care acoustics on the quality of care and physiological state of pat...