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The possible risk for strokes complicating cardiac surgery in patients with intraoperative hypothermia

Isabelle Korn-Lubetzki1, Israel Steiner, Avraham Oren

  • 1Department of Neurology, Shaare Zedek Medical Center, Jerusalem, Israel. ikl@cc.huji.ac.il

Cerebrovascular Diseases (Basel, Switzerland)
|October 16, 2010
PubMed

Insights

Intraoperative hypothermia below 30°C during cardiac surgery, especially with valve repair and coronary artery bypass grafting (CABG), may increase stroke risk. Lower temperatures around 28°C were linked to higher stroke incidence.

Area of Science:

  • Cardiology
  • Neurology
  • Surgical Outcomes

Background:

  • The neuroprotective role of hypothermia in cardiac surgery remains debated.
  • Understanding factors influencing stroke after cardiac procedures is critical.

Purpose of the Study:

  • To investigate the association between intraoperative temperature and postoperative stroke risk in cardiac surgery patients.
  • To identify specific surgical procedures and patient factors contributing to stroke.

Main Methods:

  • Retrospective analysis of cardiac surgery patients over 14 years.
  • Comparison of patients with and without postoperative stroke.
  • Multivariate analysis of pre- and intraoperative risk factors.

Main Results:

  • Stroke occurred more frequently in patients undergoing valve repair/replacement combined with coronary artery bypass grafting (CABG) versus CABG alone.
  • All strokes were ischemic, with a large-vessel etiology.
  • Intraoperative minimal temperatures below 34°C were observed in all stroke patients, with lower temperatures (<30°C) significantly associated with stroke.
  • Lower intraoperative temperature was an independent risk factor for stroke (OR 1.080/1°C).

Conclusions:

  • Intraoperative hypothermia, particularly temperatures around 28°C, may be associated with an increased risk of postsurgical stroke.
  • Specific procedures like combined valve repair/replacement and CABG may carry a higher stroke risk.
  • Maintaining optimal intraoperative temperatures is crucial for mitigating stroke risk in cardiac surgery.
Abstract

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