Neurological complications are avoidable during CABG

被引:5
作者
Haider, Zulfiqar [1 ]
Jalal, Anjum [1 ]
Alamgir, Asif Rashid [2 ]
Rasheed, Irfan [1 ]
机构
[1] Faisalabad Inst Cardiol, Dept Cardiac Surg, Faisalabad, Pakistan
[2] Faisalabad Inst Cardiol, Dept Anesthesia, Faisalabad, Pakistan
关键词
Stroke; Coronary Artery Bypass; Atheroembolism; Off-pump; Aorta; Cardio-pulmonary bypass; Morbidity; ARTERY-BYPASS-SURGERY; OFF-PUMP; CARDIOPULMONARY BYPASS; CORONARY-BYPASS; GRAFT-SURGERY; OUTCOMES; REVASCULARIZATION; IMPACT;
D O I
10.12669/pjms.341.14114
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: To review the incidence of stroke in patients undergoing CABG and the impact of a preventive strategy adopted at tertiary care unit of cardiac surgery. Methods: The data of all patients who underwent isolated CABG (N= 722) from July 2016 to August 2017 at Faisalabad Institute of Cardiology was retrieved for this retrospective study. All operations were done on cardiopulmonary bypass and cold blood cardioplegia. Numeric data was summarized as Mean +/- Standard Deviation while categoric variables were summarized into frequency and percentage. Results: Mean age of patients was 53.83 +/- 8.8 years. Mean Parsonnet and Logistic EuroScore were 4.3 +/- 3.2 and 3.3 +/- 0.9 respectively. Forty nine patients (6.78%) had significant carotid artery disease. Mean number of grafts was 2.8 +/- 0.82. Diabetes was present in 27.8% patients. Neurological complications were noticed in 14 patients (1.94%) who included 12 permanent paralyses. Further subgroup analysis revealed that 67 patients who were operated by single clamp technique remained free of neurological complications. This is clinically remarkable finding but due to small population size it is statistically non-significant. Conclusion: The incidence of neurological complications can be reduced significantly by adopting the appropriate preventing measures. Use of Single Clamp technique may be the reasons of such a low incidence of stroke in this study.
引用
收藏
页码:5 / 9
页数:5
相关论文
共 19 条
[1]   Does off-pump coronary artery bypass (OPCAB) surgery improve the outcome in high-risk patients?: a comparative study of 1398 high-risk patients [J].
Al-Ruzzeh, S ;
Nakamura, K ;
Athanasiou, T ;
Modine, T ;
George, S ;
Yacoub, M ;
Ilsley, C ;
Amrani, M .
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 2003, 23 (01) :50-55
[2]   SINGLE-CLAMP TECHNIQUE - AN IMPORTANT ADJUNCT TO MYOCARDIAL AND CEREBRAL PROTECTION IN CORONARY OPERATIONS [J].
ARANKI, SF ;
RIZZO, RJ ;
ADAMS, DH ;
COUPER, GS ;
KINCHLA, NM ;
GILDEA, JS ;
COHN, LH .
ANNALS OF THORACIC SURGERY, 1994, 58 (02) :296-303
[3]   Brain injury and neuropsychological outcome after coronary artery surgery are affected by complement activation [J].
Baufreton, C ;
Allain, P ;
Chevailler, A ;
Etcharry-Bouyx, F ;
Corbeau, JJ ;
Legall, D ;
de Brux, JL .
ANNALS OF THORACIC SURGERY, 2005, 79 (05) :1597-1605
[4]   ACC/AHA Guidelines for Coronary Artery Bypass Graft Surgery: Executive summary and recommendations - A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (committee to revise the 1991 Guidelines for Coronary Artery Bypass Graft Surgery) [J].
Eagle, KA ;
Guyton, RA ;
Davidoff, R ;
Ewy, GA ;
Fonger, J ;
Gardner, TJ ;
Gott, JP ;
Herrmann, HC ;
Marlow, RA ;
Nugent, W ;
O'Connor, GT ;
Orszulak, TA ;
Rieselbach, RE ;
Winters, WL ;
Yusuf, S ;
Gibbons, RJ ;
Alpert, JS ;
Eagle, KA ;
Gardner, TJ ;
Garson, A ;
Gregoratos, G ;
Russell, RO ;
Ryan, TJ ;
Smit, SC .
CIRCULATION, 1999, 100 (13) :1464-1480
[5]   Clinical impact of drug-eluting Stents in changing referral practices for coronary surgical revascularization in a tertiary care center [J].
Ferreira, AC ;
Peter, AA ;
Salerno, TA ;
Bolooki, H ;
de Marchena, E .
ANNALS OF THORACIC SURGERY, 2003, 75 (02) :485-489
[6]   IMPROVEMENT OF OUTCOMES AFTER CORONARY-ARTERY BYPASS - A RANDOMIZED TRIAL COMPARING INTRAOPERATIVE HIGH VERSUS LOW MEAN ARTERIAL-PRESSURE [J].
GOLD, JP ;
CHARLSON, ME ;
WILLIAMSRUSSO, P ;
SZATROWSKI, TP ;
PETERSON, JC ;
PIRRAGLIA, PA ;
HARTMAN, GS ;
YAO, FSF ;
HOLLENBERG, JP ;
BARBUT, D ;
HAYES, JG ;
THOMAS, SJ ;
PURCELL, MH ;
MATTIS, S ;
GORKIN, L ;
POST, M ;
KRIEGER, KH ;
ISOM, OW .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 1995, 110 (05) :1302-1314
[7]   Risk factors and solutions for the development of neurobehavioral changes after coronary artery bypass grafting [J].
Hammon, JW ;
Stump, DA ;
Kon, ND ;
Cordell, AR ;
Hudspeth, AS ;
Oaks, TE ;
Brooker, RF ;
Rogers, AT ;
Hilbawi, R ;
Coker, LH ;
Troost, BT .
ANNALS OF THORACIC SURGERY, 1997, 63 (06) :1613-1618
[8]   SINGLE AORTIC CLAMPING FOR PROXIMAL AND DISTAL ANASTOMOSES IN CORONARY OPERATIONS - STUDY OF MYOCARDIAL TEMPERATURES IN NONVENTED HEARTS [J].
HEATON, JPW ;
SALERNO, TA .
ANNALS OF THORACIC SURGERY, 1983, 35 (05) :530-534
[9]  
Kim Kuna, 2014, J Extra Corpor Technol, V46, P317
[10]   Single-clamp technique does not protect against cerebrovascular accident in coronary artery bypass grafting [J].
Kim, RW ;
Mariconda, DC ;
Tellides, G ;
Kopf, GS ;
Dewar, ML ;
Lin, ZQ ;
Elefteriades, JA .
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 2001, 20 (01) :127-132