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ULTIMO FASCICOLOTHE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica


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The Journal of Cardiovascular Surgery 2000 Dicembre;41(6):911-4

VASCULAR AND ENDOVASCULAR PAPERS 

 ORIGINAL ARTICLES

Preoperative cerebrovascular screening before cardiovascular surgery in a high risk area of cerebrovascular events in Japan

Takeuchi K., Maida K., Yoshida S., Midorikawa H. *, Noda H. *, Suzuki S. **, Tanaka S.

From the Depart­ment of Car­di­o­vas­cular Sur­gery *­Radiology, ­Aomori Gen­eral Hos­pital
**­First Depart­ment of Sur­gery Hir­o­saki Uni­ver­sity ­School of Med­i­cine Aomori, Japan

Back­ground. Cereb­ro­vas­cular dis­ease and cer­vical ­artery dis­eases are poten­tially treat­able con­di­tions ­that are asso­ciated ­with an ­increased inci­dence of ­stroke ­after car­diac sur­gery. ­This pros­pec­tive ­study was ­designed to deter­mine the prev­a­lence of cereb­ro­vas­cular dis­eases in the ­high ­risk pop­u­la­tion of cereb­ro­vas­cular ­event ­including ­some ­young ­patients in ­Japan and estab­lish the ­strategy for car­diac sur­gery of ­patients ­with cereb­ro­vas­cular dis­ease.
­Methods. 100 (71 ­male, 29 ­female) of 126 con­sec­u­tive ­patients under­going car­diac sur­gery ­under car­di­o­pul­mo­nary ­bypass ­were ­screened for the pres­ence of cereb­ro­vas­cular dis­ease by ­intra-arte­rial angio­gram.
­Results. In ­seven ­patients angio­graphic eval­u­a­tion dis­closed ­some evi­dence of cereb­ro­vas­cular dis­ease for 50% or ­greater sten­osis or cere­bral aneu­rysm. Pre­op­er­a­tive 99mTc-Hex­a­methyl pro­py­lene ­amino ­oxime (99mTc-­HMPAO) ­single emis­sion com­puted tomog­raphy (­SPECT) ­with com­bi­na­tion of bal­loon arte­rial occlu­sion ­test pro­vided ­detailed infor­ma­tion of cere­bral ­ischemic tol­er­ance and reli­able deci­sion ­making for sur­gical ­repair of cereb­ro­vas­cular dis­ease. No ­deaths ­were ­recorded and a ­small ­stroke in one ­patient.
Con­clu­sions. We con­cluded ­that cereb­ro­vas­cular ­screening in ­patients ­with car­di­o­vas­cular dis­ease may be ­requested in a ­high ­risk pop­u­la­tion of cereb­ro­vas­cular ­events.

lingua: Inglese


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