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Ann Thorac Surg 2005;80:1746-1750
© 2005 The Society of Thoracic Surgeons

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Original article: Cardiovascular

Stroke After Coronary Artery Bypass Grafting

Cardiac Surgical Research Group, Cardiac and Thoracic Surgery, Flinders Medical Centre and Flinders University, Bedford Park, South Australia, Australia

Accepted for publication April 28, 2005.

^_* Address correspondence to Dr Baker, Cardiac Surgical Research Unit, Department of Cardiac and Thoracic Surgery, Level 6, Flinders Private Hospital, Flinders Drive, Bedford Park, South Australia 5042 (Email: rob.baker{at}flinders.edu.au).

BACKGROUND: Despite the continuing improvements in surgical and cardiopulmonary bypass techniques during cardiac surgery, stroke remains a devastating complication. This study aimed to identify the preoperative and intraoperative risk factors for developing a perioperative stroke in patients undergoing coronary artery bypass graft surgery on cardiopulmonary bypass.

METHODS: A total of 4,380 consecutive patients who received isolated coronary artery grafting on cardiopulmonary bypass between 1992 and 2002 were included. The sample contained three cardiopulmonary bypass temperature strategies: hypothermic (< 31°C, n = 1,853), tepid (32–35°C, n = 1,088), and normothermic (> 36°C, n = 1,439). Outcome measures reported include stroke incidence, 30-day mortality, and hospital length of stay.

RESULTS: The incidence of stroke was 1.2% (n = 51). Stroke patients were older, were more likely to be diabetic, hypertensive, have creatinine levels greater than 0.12 mmol/L, and have a history of stroke than those who did not have stroke (p < 0.05). Multivariate logistic regressions identified diabetes (p = 0.01), history of stroke (p = 0.04), and older age (p = 0.05) as independent predictors of stroke for all patients. The 30-day mortality for stroke patients was ten times greater than that of those who did not suffer stroke (17.6 vs 1.7%).

CONCLUSIONS: Diabetes, history of stroke, and older age were identified as risk factors for stroke after coronary bypass; the temperature at which cardiopulmonary bypass was performed was not significant.

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