PERIOPERATIVE STROKE IN PATIENTS UNDERGOING CONVENTIONAL CORONARY ARTERY BYPASS GRAFTING (CABG)-AN EXPERIENCE AT NICVD KARACHI

Abstract

Objective: To identify the effect of duration of cardiopulmonary bypass as a risk
factor in the incidence of stroke in elective conventional surgery for coronary
artery bypass grafting (CABG).

Methodology: It was a cross-sectional, descriptive, retrospective study
conducted from 1st February 2014 to 31st January 2015 at Department of
Cardiac Anaesthesia & Surgery, National Institute of Cardiovascular Diseases
(NICVD), Karachi. All patients between 30-70 years of age undergoing elective
isolated CABG surgery were included while emergency CABG, patients with
history of TIA or stroke, patients with coronary stents, diagnosed case of atrial
fibrillation, low ejection fraction, intraoperative hemodynamic instability and renal
dysfunction were excluded. The effect of duration of cardiopulmonary bypass
with emphasis on the occurrence of stroke was analyzed in consecutive patients
who underwent conventional CABG. Variables included demographic data,
clinical symptoms, risk factors for stroke and CABG, investigations and other
surgical parameters. Chi square test was applied for comparison. Significant p
value was set for <0.05.

Results: The study included 80 (100%) patients who underwent conventional
CABG. There were 30 (37.5%) female patients with mean age of 64.6±2.1 years.
Postoperative stroke was found in 03 patients (3.75%). Out of these, stroke was
found in patients in whom bypass time was more than 100 minutes.

Conclusion: Prolonged cardiopulmonary bypass time is a common risk factor for
post CABG stroke.

Key Words: Stroke, Cardio Pulmonary Bypass, Conventional CABG, TIA