Cerebrovascular accidents after cardiac surgery: an analysis of CT scans in relation to clinical symptoms
2005 (English)In: Scandinavian Cardiovascular Journal, ISSN 1401-7431, Vol. 39, no 5, 299-305 p.Article in journal (Refereed) Published
There is a link between aortic manipulation, particle embolization, and cerebrovascular accidents (CVA) in cardiac surgery. The present aim was to study hemispheric side differences of CVA. Cardiac-surgery patients with CVA and with computer tomography (CT) performed (n = 77) were analyzed within a total group of 2641 consecutive cases. CT data were reviewed for hemispheric and vascular distribution, and compared with CVA-symptom data of immediate and delayed type. Of the included patients, 66% had positive CT. In the group of 'cardiac-type' operations (e.g., routine clamping and cannulation) and having immediate CVA, right-hemispheric lesions were more frequent than of the contra-lateral side (p = 0.005). Patients with aortic dissections had strong dominance of bilateral findings, which was different from the unilateral pattern of 'cardiac-type' operations (p = 0.001). The middle-cerebral artery territory dominated, and when involved showed a significant (p = 0.022) right-sided distribution. Both CT and clinical symptoms confirmed that CVA after cardiac surgery has a right-hemispheric predominance. These observations may imply that aortic manipulation directs embolic material towards the brachiocephalic trunk.
Place, publisher, year, edition, pages
2005. Vol. 39, no 5, 299-305 p.
Aged, Cardiac Surgical Procedures/*adverse effects, Coronary Artery Bypass, Dominance; Cerebral, Female, Humans, Intracranial Embolism/etiology, Male, Middle Aged, Postoperative Complications/radiography, Risk Factors, Stroke/etiology/*radiography, Telencephalon/radiography, Tomography; X-Ray Computed
IdentifiersURN: urn:nbn:se:umu:diva-6034DOI: 10.1080/14017430510035907PubMedID: 16269400OAI: oai:DiVA.org:umu-6034DiVA: diva2:145702