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Perioperative Strokes Following Surgical Correction of Mitral Valves: A Systematic Review and Meta-Analysis

Reshmi Udesh1, Piruthiviraj Natarajan, Vinodh Jeevanantham

  • 1Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

European Neurology
|June 26, 2017
PubMed
Abstract

Insights

Perioperative strokes after open mitral valve procedures significantly increase 30-day stroke-related mortality by over 7 times. These events may be more common than previously reported, warranting further research into prevention.

Area of Science:

  • Cardiovascular Surgery
  • Neurology
  • Critical Care Medicine

Background:

  • Open mitral valve (MV) procedures carry risks, including perioperative stroke.
  • Understanding the impact of these strokes on mortality is crucial for patient outcomes.

Purpose of the Study:

  • To quantify the association between perioperative strokes and stroke-related mortality following open MV procedures.
  • To assess the incidence of stroke and its contribution to mortality in this patient population.

Main Methods:

  • A meta-analysis was conducted using data from 25 studies retrieved via electronic searches of PubMed, Embase, and Web of Science up to December 2015.
  • The primary outcome was 30-day stroke-related mortality, with odds ratios (OR) calculated.

Main Results:

  • The overall stroke rate was 1.62%, with a 30-day all-cause mortality of 3.51%.
  • Strokes accounted for 6.87% of total deaths.
  • The summary OR for 30-day stroke-related mortality was 7.22 (95% CI 4.13-12.63, p < 0.0001).
  • Concomitant coronary artery bypass grafting showed a higher OR of 8.508 (95% CI 1.552-46.622, p = 0.0136).

Conclusions:

  • Perioperative strokes after open MV procedures are linked to a significantly increased risk of 30-day stroke-related mortality.
  • The incidence of perioperative strokes may be underestimated in current literature.
  • Further investigation into stroke mechanisms and preventive strategies is recommended.
Keywords:
In-hospital mortalityMitral valve surgeryMorbidityPerioperative stroke

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