Stroke Related to Cardiac and/or Aortic Surgery: an Overview

Abstract

In recent years there has been an increasing awareness of atheromatous disease of the aorta and its role has become more evident in relation to neurologic deficits following cardiac and aortic surgery. Specific surgical events can release emboli blocking cerebral arteries and cause catastrophic neurologic sequelae plagueing the patients, their families and the health care system.

The extent of the problem is illustrated and the pathophysiologic mechanisms are explained. Special attention is given to the calcified aorta and the preventive actions that can be undertaken by the surgeon to avoid cerebral damage. Aortic surgery cannot be separated from cardiac surgery and therefore specific aortic problems related to cerebral damage are highlighted such as aortic dissection and aortic arch replacement.

Key Words:

• Stroke
• cardiac surgery
• aortic surgery
• aortic dissection
• embolisation
• extracorporeal circulation
• encephalopathy
• cognitive dysfunction
• endoballoon
• aortic filter

Additional information

Notes on contributors

M.A. Schepens

M. A. Schepens, M.D., Ph.D. st. Antonius Hospital Dep. Cardiovascular an d Thoracic Surgery Koekoekslaan 1 3435 cM Nieuwegein The Netherlands Tel.: [phone]. Fax: [phone]. E-mail: [email protected]