Relationship Between Cardiac Surgery and Acute Ischemic Stroke: An Examination in Terms of Clinical, Radiological, and Functional Outcomes and Possible Pathophysiological Mechanisms

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dc.contributor.authorIsik, Mehmet
dc.contributor.authorKozak, Hasan Huseyin
dc.contributor.authorGormus, Niyazi
dc.date.accessioned2024-02-23T14:29:57Z
dc.date.available2024-02-23T14:29:57Z
dc.date.issued2021
dc.departmentNEÜen_US
dc.description.abstractAim: The aim is to discuss the clinical characteristics, time, anatomical vascular distribution, radiological features, functional outcomes after stroke and possible pathophysiological mechanisms of acute ischemic stroke (AIS) that develop after cardiac surgery. Method: A total of 3,474 patients, who underwent cardiac surgery between 2015-2020, retrospectively were analyzed. Forty-nine patients, who developed AIS and had brain CT and diffusion MR images during hospitalization, were included in the study. Results: AIS distribution was at 53% CABG, 12.2% isolated mitral valve, 8.1% isolated aortic valve, and 26.5% combined surgical procedures. Patients with a <= 2 days (P = 0.03) preop preparation time and body surface area (BSA) of <1.85 m2 (P = 0.02) had a high discharge rate. While newly developing AF was low in the early stroke group, it was higher in the late stroke group (P = 0.02). A history of previous cerebrovascular events was found in 3.3% of the patients. Postoperative new AIS was detected in 7.8% of those with a history of cerebrovascular events. Total anterior circulation infarction (TACI) case rate was 8.1%, partial anterior circulation infarction (PACI) 12.2%, posterior circulation infarction (POCI) 24.4%, cortical border zone infarction (CBZI) 30.6%, combined POCI + CBZI 12.2%, multiple territorial infarcts (MTI) 10.2%, and lacunar circulation infarction (LACI) rate was 2%. The modified Rankin Scale means following AIS was 3.45. The worst Rankin score was 5.75 in CABG+MVR cases; it was found to be 5 in the valve + ascending aorta case and 5 in the five bypass cases. Conclusion: Calculation of cerebrovascular reserve with extra/intracranial vascular imaging is important in patients with multiple risk factors, whose association with stroke has been determined before cardiac surgery. We believe that cardiovascular surgery and neurology multidisciplinary prospective randomized studies should be conducted to obtain pre-, peri-and post-procedural risk calculation scales, according to cardiac surgery type and to reshape surgical procedures accordingly.en_US
dc.identifier.doi10.1532/hsf.4007
dc.identifier.endpageE723en_US
dc.identifier.issn1098-3511
dc.identifier.issn1522-6662
dc.identifier.issue4en_US
dc.identifier.pmid34473018en_US
dc.identifier.scopus2-s2.0-85117623169en_US
dc.identifier.scopusqualityQ3en_US
dc.identifier.startpageE713en_US
dc.identifier.urihttps://doi.org/10.1532/hsf.4007
dc.identifier.urihttps://hdl.handle.net/20.500.12452/14943
dc.identifier.volume24en_US
dc.identifier.wosWOS:000701687500028en_US
dc.identifier.wosqualityQ4en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherForum Multimedia Publishing, Llcen_US
dc.relation.ispartofHeart Surgery Forumen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subject[Keyword Not Available]en_US
dc.titleRelationship Between Cardiac Surgery and Acute Ischemic Stroke: An Examination in Terms of Clinical, Radiological, and Functional Outcomes and Possible Pathophysiological Mechanismsen_US
dc.typeArticleen_US

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