Stroke after heart valve surgery: a single center institution report

Area of Science:

• Cardiovascular Surgery
• Neurology
• Public Health

Background:

• Stroke is a significant complication following heart valve replacement surgery, with incidence rates between 1% and 10%.
• Postoperative stroke impacts patient outcomes and increases healthcare costs.
• Identifying risk factors for stroke after valve replacement is crucial for improving patient care.

Purpose of the Study:

• To investigate the incidence of in-hospital adverse neurologic events, specifically stroke, after surgical valve replacement (SVR).
• To identify patient characteristics and procedural factors associated with an increased risk of stroke.
• To analyze the outcomes associated with postoperative stroke in SVR patients.

Main Methods:

• Retrospective analysis of 417 consecutive patients undergoing SVR from January 2004 to December 2022.
• Data extracted from a prospectively recorded cardiac intensive care unit database.
• Inclusion of demographic, preoperative, and perioperative variables; exclusion of specific criteria.

Main Results:

• The incidence of postoperative stroke was 4.3%.
• Risk factors identified include prolonged cardiopulmonary bypass and aortic cross-clamp times, prior stroke, diabetes mellitus, mitral valve annulus calcification, combined procedures (AVR/MVR, CABG/AVR/MVR), internal carotid artery stenosis (<75%), and need for prolonged inotropic support.
• Stroke occurrence correlated with longer ICU stays and increased in-hospital mortality.

Conclusions:

• Key risk factors for stroke following SVR have been identified.
• Proactive measures are essential to mitigate the incidence of postoperative stroke in patients undergoing valve replacement surgery.