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Published on: October 20, 2016
Chiasmal stroke following open-heart surgery.
Ido Didi Fabian1, Gahl Greenberg, Ruth Huna-Baron
1Goldschleger Eye Institute, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel. didifabian@gmail.com
Summary
Chiasmal stroke, a rare complication of open-heart surgery, can cause vision loss. This case highlights the risk of optic chiasm infarction following aortic valve replacement.
Area of Science:
- Ophthalmology
- Neurology
- Cardiovascular Surgery
Background:
- Open-heart surgery, such as aortic valve replacement, carries various potential risks.
- Visual pathway complications are infrequently reported but significant.
- Understanding these risks is crucial for patient management and surgical planning.
Observation:
- A 62-year-old male patient experienced sudden vision loss in his right eye and a left temporal visual field defect post-aortic valve replacement.
- Automated visual field testing revealed a right-sided anterior junction syndrome.
- Magnetic Resonance Imaging (MRI) confirmed a right-sided chiasmal infarct.
Findings:
- The patient presented with symptoms consistent with a stroke affecting the optic chiasm (chiasmal infarct).
- The neurological deficit was directly linked to the recent cardiovascular surgical procedure.
- This case underscores the potential for cerebrovascular events in the optic pathway during cardiac surgery.
Implications:
- Chiasmal stroke is a rare but serious complication associated with open-heart surgery.
- Ophthalmologists and neurologists should consider this possibility in patients with visual disturbances post-cardiac procedures.
- Further research may elucidate specific risk factors and preventative strategies for visual pathway injury during cardiac surgery.
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