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Symptomatic subdural hemorrhage following heart valve surgery: a retrospective cohort study

Sotaro Oshida1, Junichi Tsuboi2, Hajime Kin2

  • 1Departments of1Neurosurgery and.

Journal of Neurosurgery
|February 15, 2023
PubMed

Insights

Subdural hemorrhage (SDH) occurred in 2.0% of patients after heart valve surgery. Longer aortic clamp times, increased heparin dosage, and higher pulmonary artery pressure were linked to SDH development.

Area of Science:

  • Neurosurgery
  • Cardiovascular Surgery
  • Neurology

Background:

  • Subdural hemorrhage (SDH) is a known complication after open heart surgery.
  • Clinical features and pathophysiology of SDH post-cardiac surgery require further elucidation.

Purpose of the Study:

  • To determine the incidence and clinical course of symptomatic SDH after heart valve surgery.
  • To identify factors associated with the development of SDH following heart valve surgery.

Main Methods:

  • Retrospective review of 556 patients undergoing heart valve surgery with cardiopulmonary bypass (CPB).
  • Analysis of preoperative cranial CT or MRI scans.
  • Logistic regression analysis to identify associated factors.

Main Results:

  • Symptomatic SDH occurred in 2.0% of patients, with onset 2-37 days post-surgery.
  • 90.9% of SDH cases were located in the posterior fossa or occipital convexity.
  • Longer aortic clamp time, higher post-operative heparin dose, and elevated pulmonary artery pressure (PAP) before CPB disconnection were significant risk factors.

Conclusions:

  • The incidence of symptomatic SDH after heart valve surgery is 2.0%.
  • SDH typically manifests within a month post-surgery, often in the posterior fossa or occipital regions.
  • Key factors associated with SDH include prolonged aortic clamp time, increased heparin administration, and elevated PAP during CPB.
Abstract

Keywords:
cardiopulmonary bypassheart valve surgeryposterior fossasubdural hemorrhagevascular disorders, endovascular neurosurgery

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