Perioperative stroke after coronary artery bypass grafting in elderly patients
Abstract
Aim. According to the literature data the stroke incidence is about 3% in patients after coronary
artery bypass grafting. Perioperative stroke increases the risk of mortality, postoperative hospital
stay and care. Hospital expenses for the treatment of stroke increase for 10 times.
Methods. Retrospective analysis was performed in elderly patients after coronary artery bypass
grafting within the period since April 2009 till June 2011. 158 patients were included in the study.
Patients were divided into two groups. The first group collected patients which underwent off-
pump coronary artery bypass grafting (79 pts). Patients operated on pump were included in the
second group (79 pts).
Results. Atherosclerosis of ascending aorta was identified by palpation and by epiaortic ultrasound
examination in 40 (50.6%) cases of the 1st group and in 37 (46.8%) cases of the 2nd group (р>0.05).
Cannulation and cross clamping of aorta were performed in places free from atherosclerosis in the
2nd group. In order to avoid manipulation with aorta we used «no touch aorta» technique in the 1st
group. T-graft or Y-graft were performed in 34 (43.1%) cases. Proximal anastomosis were formed
with Heart String III devise in 6 (7.6%) patients. No cases of stroke were registered in the 1st group.
In the 2nd group stroke occurred in 2 (2.5%) patients.
Conclusion. The results of the study are consistent with published data and demonstrate that
avoidance of manipulation with aorta during coronary artery bypass grafting may minimize incidence of stroke.
Keywords:stroke, coronary artery bypass grafting (CABG), elderly patients
Clin. Experiment. Surg. Petrovsky J. 2016. № 4. Р. 22–26.
Received: 01.09.2016. Accepted: 17.09.2016.
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