Management of perioperative stroke

Amer Malik, Lawrence R. Wechsler

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Stroke is currently recognized as the third most common cause of death and the leading cause of adult morbidity in the United States, affecting nearly 795,000 people annually (Circulation 2009). Perioperative ischemic stroke is an important concern when cardiac surgeries are undertaken. Approximately one million patients worldwide undergo cardiac surgeries annually and coronary artery bypass grafting (CABG) is the most frequent major cardiovascular operation performed. Cardiac surgery is associated with higher perioperative stroke risk compared with general, noncardiac procedures (Arch Neurol 66:1062-64, 2009; Cerebrovasc Dis 18:37-46, 2004; Ann Thorac Surg 75:472-8, 2003; Stroke 37:562-71, 2006; Eur J Vasc Endovasc Surg 23:283-94, 2002; Ann Otol Rhinol Laryngol 102:717-23, 1993). Perioperative ischemic stroke occurs in an estimated 2-6% of CABG surgeries and is often related to the complexity and type of surgery being performed. In patients older than 75 years of age, incidence approaches 9% and is more than twice that of patients 65-74 years old and more than nine times that of patients less than 65 years old (J Thorac Cardiovasc Surg 104:1510-7, 1992). When combined cardiac surgeries (e.g., CABG and valve surgery) are pursued, the incidence of perioperative ischemic stroke tends to be even higher (Stroke 37:562-71, 2006; Eur J Vasc Endovasc Surg 23:283-94, 2002).

Original languageEnglish (US)
Title of host publicationRedo Cardiac Surgery in Adults
PublisherSpringer New York
Pages29-35
Number of pages7
Volume9781461413264
ISBN (Print)9781461413264, 1461413257, 9781461413257
DOIs
StatePublished - Jun 1 2012
Externally publishedYes

ASJC Scopus subject areas

  • Medicine(all)

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