Assessment of Stroke and Concomitant Cerebrovascular Disease with Heart Disease Requires Invasive Treatment: Analysis of 249 Consecutive Patients with Heart Disease

Myeong Jin Kim; Hyun Song; Se-yang Oh; Jai Ho Choi; Bum-soo Kim; Joonkyu Kang; Yong Sam Shin

doi:10.1055/s-0033-1356748

The Thoracic and Cardiovascular Surgeon, Inhaltsverzeichnis

Thorac Cardiovasc Surg 2014; 62(04): 317-323
DOI: 10.1055/s-0033-1356748

Original Cardiovascular

Georg Thieme Verlag KG Stuttgart · New York

Assessment of Stroke and Concomitant Cerebrovascular Disease with Heart Disease Requires Invasive Treatment: Analysis of 249 Consecutive Patients with Heart Disease

Myeong Jin Kim

¹Department of Neurosurgery, Gachon University Gil Medical Center, Incheon, Republic of Korea

,

Hyun Song

²Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, The Catholic University, Seoul, Republic of Korea

,

Se-yang Oh

³Department of Neurosurgery, Seoul St. Mary's Hospital, The Catholic University, Seoul, Republic of Korea

,

Jai Ho Choi

³Department of Neurosurgery, Seoul St. Mary's Hospital, The Catholic University, Seoul, Republic of Korea

,

Bum-soo Kim

⁴Department of Radiology, Seoul St. Mary's Hospital, The Catholic University, Seoul, Republic of Korea

,

Joonkyu Kang

²Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, The Catholic University, Seoul, Republic of Korea

,

Yong Sam Shin

³Department of Neurosurgery, Seoul St. Mary's Hospital, The Catholic University, Seoul, Republic of Korea

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Abstract

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Abstract

Purpose The aim of this study was to analyze the relationships of cerebrovascular disease (CVD), heart problems, and stroke in patients who required an invasive cardiac procedure.

Materials and Methods We enrolled 249 consecutive patients who required to or underwent invasive cardiac treatment and divided into a non-CVD group (n = 116) and a CVD group (n = 133). The latter group was divided into a coronary artery disease (CAD) group (n = 118) and a non-CAD group such as cardiac structural lesions (n = 15).

Results No significant relationship with significant cerebrovascular stenosis was observed in either the CADs or non-CADs. The incidence of past stroke was significantly higher in the CVD group than that in the non-CVD group (12.8 vs. 3.4%; p = 0.017). Previous stroke event had increased odds of having significant cerebrovascular stenosis (odds ratio, 3.919, p = 0.006). In patients with both cardiac disease and the CVD, perioperative stroke was only one case (0.9%). The main source of stroke was cardiogenic in the immediate results and cerebrovascular lesions in the delayed results (1–12 months).

Conclusion The risk of perioperative stroke was very low in combined cardiac disease and the CVD. However, for preventing ischemic stroke due to the predetected cerebrovascular lesions, precautionary efforts could be needed for patients undergoing an invasive cardiac procedure, and concomitant cerebrovascular lesions should be considered as main source of delayed ischemic stroke.

Keywords

coronary artery bypass graft - heart valve surgery - stroke - carotid arteries - atherosclerosis

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Referenzen

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