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Ann Thorac Surg 1999;68:1465
© 1999 The Society of Thoracic Surgeons

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Supplement: Outcomes ’99: Scientific Abstracts

Stroke following coronary artery bypass graft surgery

^a Cardiac Surgical Research Group, Flinders Medical Centre, South Australia, Australia
^b Ashford Community Hospital, South Australia, Australia

Background: Normothermic perfusion techniques are now utilized in coronary artery bypass graft surgery (CABG), however a major concern limiting their acceptance is related to the increased incidence of stroke reported by some investigators. The aim of this study was to examine the incidence and factors associated with stroke in CABG patients.

Methods: Data was collected prospectively on 3311 consecutive CABG cases; 2187 patients underwent whole body moderate hypothermia (30 to 32°C), while 1124 underwent normothermic bypass (36 to 37°C).

Results: Demographic variables between the two groups were similar. Major indicators of outcome, mortality, and myocardial infarction were not different between the two groups. The overall incidence of stroke in the sample was 0.9% (30 of 3311). The incidence of stroke significantly increased the risk of mortality (odds ratio 9.35; confidence interval 3.7–23.3). Incidence of stroke was significantly greater with age > 70 (1.4%:0.7%; OR 2.07, CI 1.0–4.27), preexisting cerebrovascular disease (3.6%:0.6%; 6.12 (2.86–14.4)), history of stroke (4.8%:0.8%; 6.2 (1.97–19.81)), renal disease (creatinine > 0.2, 7.3%:0.8%; 10.29 (4.09–25.90)) and hypertension (1.4%:0.5%; 2.77 (1.26–6.10)). In the hypothermic group incidence of stroke was 18 of 2187 (0.8%) and in the normothermic group 12 of 1124 (1.1%) (not significant). Previous cerebrovascular disease, history of stroke and renal disease were associated with increased incidence of stroke in patients from each group. Incidence of postoperative frank psychosis was not different between the groups, however an increase in transient postoperative confusion was evident in the normothermic group (3.7%:7.3%, p < 0.001). Neuropsychological assessment performed on 117 patients (55 hypothermic: 62 normothermic), showed no difference in the number of test declines.

Conclusions: Normothermic whole body perfusion does not appear to increase the risk of stroke, nor change the risk factors associated with stroke.

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Baker, R.A. Articles by Knight, J.L. Search for Related Content PubMed Articles by Baker, R.A. Articles by Knight, J.L.