Cardiac Surgery

Background:  Perioperative stroke can prove to be a detrimental complication after cardiac surgery. The purpose of this study is to determine if the combined use of epiaortic ultrasound and cerebral oximetry in patients undergoing on-pump coronary bypass surgery reduces the incidence of perioperative stroke.
Methods: In 306 consecutive patients undergoing on-pump surgery, epiaortic ultrasound and cerebral oximetry were utilized. A stroke risk index was utilized to calculate the predicted risk of stroke for the entire population and in high-risk sub groups. The observed and expected rates of perioperative stroke were compared.
Results: Two patients (0.7%, 95% CI: 0.18%-2.4%) patients suffered a perioperative stroke - lower than the expected risk of stroke (2.99%). We also investigated the risk of stroke in some high-risk patients. In patients with documented atherosclerosis of the ascending aorta, the stroke rate was 2.90% (95% CI: 0.51-14.50%), compared to the expected rate of 4.71%; in patients with vascular disease, it was 0.84% (95% CI: 0.15%-4.61%), versus the expected rate of 4.64%; and in patients older than 70 years, it was 0% (95% CI: 0%-92%), while the expected rate was 5.13%. There were no transient ischemic attacks, coma or mortality associated with neurological adverse events.
Conclusions: This simple intraoperative strategy seems to be effective in reducing the incidence of perioperative stroke in patients undergoing on-pump surgery, even in relatively high-risk populations. This strategy is simple, practical, non time-consuming and is easily applicable in a variety of settings.

Methods: One hundred and ninety-five consecutive patients (103 male and 92 female), age 69 ± 8 years, underwent surgery between January 2006 and July 2007. Mean preoperative New York Heart Association function class was 2.2 ± 0.7. Thirty-five patients (18%) had an ...

Contractile responses varied greatly in HSV harvested for autologous vascular and coronary bypass procedures (0.04198 ± 0.008128 × 10 5 N/m 2 to 0.1192 ± 0.02776 × 10 5 N/m 2 ). Contractility of the HSV correlated with the cellular viability of the grafts. In the PSV model, manual ...

We have read with great interest the study by Zhao et al. (1), which concluded that intraoperative coronary angiography should perhaps eventually become the standard of care for coronary artery bypass grafting (CABG) surgery. We ask, is it really necessary to perform it routinely? ...