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Ann Thorac Surg 2005;80:2372-2374
© 2005 The Society of Thoracic Surgeons

Case report

Neurological Monitoring and Off-Pump Surgery in a Very High-Risk Stroke Patient

Mark F. Berry, MD a , Michael L. McGarvey, MD b , Li Zeng, MD c , Y. Joseph Woo, MD a , *

a Division of Cardiothoracic Surgery, Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
b Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
c Department of Anesthesia, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania

Accepted for publication June 16, 2004.

* Address correspondence to Dr Woo, 3400 Spruce St, 6 Silverstein Pavilion, Philadelphia, PA19104–4227 (Email: wooy{at}uphs.upenn.edu).

Stroke remains a high risk of coronary artery bypass grafting. We present a patient with progressively symptomatic coronary disease and severe four-vessel cerebrovascular disease not amenable to revascularization. This patient underwent coronary revascularization without neurologic complication using off-pump coronary surgery to avoid aortic manipulation and intraoperative electroencephalographic monitoring of cerebral perfusion. This management strategy may reduce the stroke risk in similar patients.






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