The Japanese Journal of Thoracic and Cardiovascular Surgery

, Volume 49, Issue 5, pp 282–286

Impact of immediate cerebral angiography for in-hospital cerebral thromboembolism after cardiovascular surgery

Authors

  • Ikuo Fukuda
    • Department of Cardiovascular SurgeryTsukuba Medical Center Hospital
  • Seigo Gomi
    • Department of Cardiovascular SurgeryTsukuba Medical Center Hospital
  • Kotoo Meguro
    • Department of NeurosurgeryTsukuba Medical Center Hospital
  • Mitsuyoshi Wada
    • Department of RadiologyTsukuba Medical Center Hospital
Article

DOI: 10.1007/BF02913134

Cite this article as:
Fukuda, I., Gomi, S., Meguro, K. et al. Jpn J Thorac Cardiovasc Surg (2001) 49: 282. doi:10.1007/BF02913134

Abstract

Objectives: Postoperative stroke remains a serious problem in cardiovascular surgery. We studied the role of cerebral angiography in postcardiotomy stroke.Methods: We retrospectively analyzed 5 in-hospital patients with stroke due to cerebral thromboembolism after cardiovascular surgery.Results: The incidence of inhospital cerebral thromboembolism was 0.5%, involving 5 patients among 913 adults undergoing cardiovascular operations. In-hospital cerebral thromboembolism occurred 3 to 9 days (average: 7±2 days) after surgery. Causes of cerebral thromboembolism were chronic atrial fibrillation in 1, transient atrial fibrillation in 2, artificial valve in 1, and intracranial arterial stenosis in 1. Immediate cerebral angiography, after exclusion of intracranial hemorrhage and complete cerebral infarction by computed tomography, revealed cerebral embolism in 3 and cerebral thrombosis in 2 with occlusion or stenosis of intracranial arteries. Local intraarterial administration of a thrombolytic agent was done in the 3 patients with cerebral embolism and occluded arteries were recanalized. Fibrinolysis was not done in 2 because of recanalized arteries or sufficient peripheral blood supply through collateral feeders. No patients exhibited rebleeding into the pericardial space or wound bleeding. All patients survived with moderate or full functional recovery.Conclusion: Immediate cerebral angiography with/without local thrombolysis may improve functional outcome and survival in patients with postcardiotomy cerebral thromboembolism.

Key words

cerebral embolismcardiac surgerystrokelocal fibrinolysis
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Copyright information

© Japanese Association for Thoracic Surgery 2001