JTCS Speed Up Your Browser
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Thomas Schachner
Johannes Bonatti
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Schachner, T.
Right arrow Articles by Bonatti, J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Schachner, T.
Right arrow Articles by Bonatti, J.
Related Collections
Right arrow Great vessels

J Thorac Cardiovasc Surg 2005;130:485-490
© 2005 The American Association for Thoracic Surgery

Surgery for Acquired Cardiovascular Disease

Risk factors for late stroke after coronary artery bypass grafting

Thomas Schachner, MD * , Anne Zimmer, Georg Nagele, MD, Guenther Laufer, MD, Johannes Bonatti, MD

Department of Cardiac Surgery, Innsbruck Medical University, Innsbruck, Austria.

Received for publication November 8, 2004; revisions received December 6, 2004; accepted for publication December 23, 2004.

* Address for reprints: Thomas Schachner, MD, Innsbruck Medical University, Department of Cardiac Surgery, Innsbruck, Austria. (Email: Thomas.Schachner{at}uibk.ac.at).

BACKGROUND: Postoperative stroke is a severe complication immediately after coronary artery bypass grafting, and it significantly deteriorates the postoperative quality of life if it occurs in the long term. It was the aim of our study to determine factors associated with the occurrence of new strokes during long-term follow-up after coronary artery bypass grafting.

METHODS: From 387 of 500 patients undergoing coronary artery bypass grafting (age, 67 years [33–84 years]; 76% male) who had intraoperative epiaortic ultrasonography for assessment of ascending aortic wall thickness, a complete follow-up regarding postoperative stroke was achieved. The median follow-up time was 52 months (9–74 months).

RESULTS: A stroke occurred in 26 (7%) of 387 patients, and the cumulative freedom from stroke was 99%, 95%, and 89% after 1, 3, and 5 years, respectively. A significantly lower freedom from stroke was present in patients with an age of 70 years or more (P = .007), preoperative unstable angina (P = .031), chronic obstructive pulmonary disease (P = .009), carotid artery disease (P < .001), preoperative history of neurologic events (P < .001), and a maximum ascending aortic wall thickness of 4 mm or more (P = .010). Multivariate analysis revealed preoperative history of neurologic events (P = .021) to be an independent risk factor.

CONCLUSION: Patients with ascending aortic atherosclerosis, older age (≥70 years), preoperative unstable angina, chronic obstructive pulmonary disease, and carotid artery disease are at risk for late postoperative stroke after coronary artery bypass grafting. A history of neurologic events is of special predictive importance.




This article has been cited by other articles:


Home page
 CirculationHome page
P. S. Shekar
On-Pump and Off-Pump Coronary Artery Bypass Grafting
Circulation, January 31, 2006; 113(4): e51 - e52.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2005 by The American Association for Thoracic Surgery.