Ann Thorac Surg 2003;75:478
© 2003 The Society of Thoracic Surgeons
Invited commentary
Markus K. Heinemann, MD, PhD
Professor of Pediatric Cardiac Surgery, Mainz University Hospital, Langenbeckstr 1, # 505 55131 Mainz, Germany
e-mail: heinemann{at}uni-mainz.de
Dr Bucerius and colleagues have collected an impressive amount of information in a high-volume German center. Data entered prospectively into a complex database, obviously utilized also to generate patient charts, were analyzed retrospectively in order to determine risk factors for neurologic injury. The highest incidence of such events was found in the valve surgery patients, in whom the suggested increased use of beating heart surgery is not an option.
The true importance of this paper lies in the wealth of meticulously documented parameters in an almost incredible cohort of more than 16,000 patients. Surely, the predictors found to be significantly associated with stroke and its detrimental sequelae must have an impact on patient selection as well as the development of preventive strategies. Only by carefully studying a large experience, such as the one reported in this paper, and by comparing the obvious and also the hidden findings to one’s own practice, will we be able to draw our own conclusions and thus to serve our patients better.
