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[Perioperative stroke in heart valve surgery: pathogenesis, clinical findings, diagnosis, prevention, treatment]

N V Tsygan1, R V Andreev2, A S Peleshok3

  • 1Kirov Military Medical Academy, St. Petersburg, Russia; Konstantinov Petersburg Nuclear Physics Institute, Gatchina, Russia.

Zhurnal Nevrologii I Psikhiatrii Imeni S.S. Korsakova
|June 5, 2018
PubMed

Insights

This study investigated perioperative stroke and cerebral dysfunction in heart valve surgery patients. Preventive cytoflavin use may reduce stroke and delirium frequency and severity.

Area of Science:

  • Cardiology
  • Neurology
  • Surgical Outcomes

Background:

  • Heart valve surgery, particularly with cardiopulmonary bypass, carries risks of neurological complications.
  • Perioperative stroke and cerebral dysfunction are significant concerns impacting patient recovery.

Purpose of the Study:

  • To identify risk factors and clinical characteristics of perioperative stroke and cerebral dysfunction.
  • To explore prevention strategies for these neurological events in heart valve surgery.

Main Methods:

  • The study included 83 patients undergoing heart valve surgery with cardiopulmonary bypass.
  • Data collected included patient demographics, surgical details, and postoperative neurological assessments.

Main Results:

  • Postoperative cerebral dysfunction occurred in 37.3% of patients; perioperative stroke in 3.6%.
  • Aortic stenosis cases showed a 9.5% perioperative stroke rate, with cardioembolic stroke being most common.
  • Risk factors for delirium included age >75, preoperative frontal dysfunction, and prolonged mechanical ventilation.

Conclusions:

  • Perioperative stroke and symptomatic delirium are notable risks following heart valve surgery.
  • Preventive administration of cytoflavin shows promise in mitigating the incidence and severity of these complications.
Abstract

Keywords:
cardiopulmonary bypasscytoflavindelayed cognitive impairmentheart valve surgeryperioperative strokepostoperative cerebral dysfunctionsymptomatic delirium of the early postoperative period

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