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Updated: Aug 7, 2026

Permanent Cerebral Vessel Occlusion via Double Ligature and Transection
Published on: July 21, 2013
[Cerebral infarction after the cardiovascular operation]
1Department of Cardiovascular Surgery, Omiya Medical Center, Jichi Medical School, Japan.
Insights
Perioperative cerebral infarction occurred in 16 of 615 patients undergoing cardiovascular surgery. Watershed infarction risk factors included older age and longer procedures, while embolism risks involved male sex and aortic calcification.
Area of Science:
- Neurology
- Cardiovascular Surgery
- Radiology
Background:
- Cardiopulmonary bypass is used in cardiovascular operations.
- Perioperative cerebral infarction is a complication.
Purpose of the Study:
- To evaluate the etiology of perioperative cerebral infarction after cardiovascular surgery.
- To identify risk factors for watershed infarction and cerebral embolism.
Main Methods:
- Retrospective review of 615 adult patients undergoing cardiovascular surgery from 1990-1994.
- Neurological evaluation of pre and postoperative brain CT findings.
- Analysis of risk factors associated with watershed infarction and cerebral embolism.
Main Results:
- Sixteen patients (2.6%) suffered perioperative cerebral infarction.
- Watershed infarction occurred in 10 patients; cerebral embolism in 6 patients.
- Risk factors for watershed infarction: elderly, emergency surgery, longer operative and bypass times.
- Risk factors for embolism: male sex, prior cerebral infarction, ascending aorta calcification.
Conclusions:
- Watershed infarction and cerebral embolism are significant complications of cardiovascular surgery.
- Identifying and mitigating risk factors is crucial for prevention.
- Preventive strategies against watershed infarction are important.
Abstract:
From January, 1990 through July 1994, 615 adult patients were undergone cardiovascular operation under the cardiopulmonary bypass. Sixteen patients were suffered perioperative cerebral infarction. The etiology of the cerebral infarction was evaluated on the pre and postoperative brain CT findings by the neurologists. In the 283 coronary artery bypass operations, 4 patients suffered watershed infarction (WS) and 4 cerebral embolism. In the 252 valve operations, one WS and one embolism. In the 80 thoracic aortic operations, 5 WS and one embolism, respectively. The risk factors of WS were the elderly, emergency, the longer operative period, and the longer cardiopulmonary bypass period. The risk factor of the embolism were male, preoperative cerebral infarction, the calcified finding of the ascending aorta by the chest CT. It is important to take preventive strategies against the watershed infarction.
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