Evaluation of Relationship of Prior Stroke History with New Stroke After Cardiac Surgery

Objectives: In this study, the preoperative stroke history of cardiac surgery cases was investigated.The relationships between previous stroke, vascular distribution areas related to stroke, stroke-related factors, preoperative modified rankin scale (mRs), and postoperative outcomes of patients were researched. Materials and Methods:From 2013-2021, 3154 patients undergoing cardiac surgery were retrospectively investigated.The study included 106 patients with a preoperative stroke history brain computed tomography and diffusion magnetic resonance images taken. Results:The preoperative stroke type distribution was 86.8% ischemic stroke, 6.6% transient ischemic stroke, 4.7% hemorrhage and 1.8% subarachnoid hemorrhage.Analysis of patients with preoperative ischemic stroke history (n: 92), indicated significant correlations between the presence of chronic atrial fibrillation (p=0.01) and mRs (p=0.02)postoperative acute ischemic stroke (AIS) development.Postoperatively, 9.4% developed AIS.The postoperative AIS distribution was 5.5% for off-pump coronary artery bypass grafting (CABG), 9.3% for on-pump CABG, and 15.3% for CABG + valve surgery.In the whole study group and the group with postoperative AIS, the proportions of the duration between previous stroke and surgery were found to be similar.For all patients in the study group, the preoperative mean mRs was 0.61, 0.92 for patients who died, and 1.0 for those who developed postoperative AIS. Conclusion:As preoperative mRs increased, the number of patients experiencing postoperative stroke increased, and the mean mRs of patients who died postoperatively was higher.Another parameter in determining the correct time between stroke and surgery could be the preoperative mRs score.