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Redo Cardiac Surgery in Adults pp 29–35Cite as

Management of Perioperative Stroke

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Abstract

Stroke is currently recognized as the third most common cause of death and the leading cause of adult morbidity in the United States, affecting nearly 795,000 people annually (Circulation 2009). Perioperative ischemic stroke is an important concern when cardiac surgeries are undertaken. Approximately one million patients worldwide undergo cardiac surgeries annually and coronary artery bypass grafting (CABG) is the most frequent major cardiovascular operation performed. Cardiac surgery is associated with higher perioperative stroke risk compared with general, noncardiac procedures (Arch Neurol 66:1062–64, 2009; Cerebrovasc Dis 18:37–46, 2004; Ann Thorac Surg 75:472–8, 2003; Stroke 37:562–71, 2006; Eur J Vasc Endovasc Surg 23:283–94, 2002; Ann Otol Rhinol Laryngol 102:717–23, 1993). Perioperative ischemic stroke occurs in an estimated 2–6% of CABG surgeries and is often related to the complexity and type of surgery being performed. In patients older than 75 years of age, incidence approaches 9% and is more than twice that of patients 65–74 years old and more than nine times that of patients less than 65 years old (J Thorac Cardiovasc Surg 104:1510–7, 1992). When combined cardiac surgeries (e.g., CABG and valve surgery) are pursued, the incidence of perioperative ischemic stroke tends to be even higher (Stroke 37:562–71, 2006; Eur J Vasc Endovasc Surg 23:283–94, 2002).

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Author information

Authors and Affiliations

  1. Department of Neurology, UPMC Stroke Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    Amer M. Malik MD, MBA

  2. Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    Lawrence R. Wechsler MD

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  1. Amer M. Malik MD, MBA
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  2. Lawrence R. Wechsler MD
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Correspondence to Lawrence R. Wechsler MD .

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Editors and Affiliations

  1. Centre Ave 5200, Pittsburgh, 15232-1300, Pennsylvania, USA

    V.R. Machiraju

  2. , Division of Cardiovascular Surgery, Mayo Clinic, First Street SW 200, Rochester, 55905, Minnesota, USA

    Hartzell V. Schaff

  3. , Department of Thoracic and Cardiovascula, Cleveland Clinic Foundation, Euclid Avenue 9500, Cleveland, 44195, Ohio, USA

    Lars G. Svensson

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Malik, A.M., Wechsler, L.R. (2012). Management of Perioperative Stroke. In: Machiraju, V., Schaff, H., Svensson, L. (eds) Redo Cardiac Surgery in Adults. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-1326-4_4

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  • DOI: https://doi.org/10.1007/978-1-4614-1326-4_4

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