STROKE AFTER CORONARY ARTERY BYPASS GRAFTING; A SINGLE CENTRE STUDY

Abstract

Objective: To determine the frequency of perioperative stroke after conventionalcoronary artery bypass grafting.

Methodology: This cross sectional study included the data of patients whounderwent conventional on-pump coronary artery bypass grafting (CABG) fromJanuary to December 2014 at Cardiac Surgery Unit of Chaudhry Pervaiz ElahiInstitute of Cardiology. Patients who underwent valvular operations, off-pumpCABG, root replacement and those who failed to wean off from cardiopulmonarybypass were excluded. Occurrence of any new permanent or transient neurologicdeficit was defined as perioperative stroke. Multi-nomial logistic regression wasapplied to determine the effect of risk factors on perioperative stroke. Odds ratioand p value were calculated for each variable. p<0.05 was taken as significant.

Result: Out of 500 patients, 86% patients were males. The incidence ofperioperative stroke was 1.8%. The need of high dose of inotropic support onweaning from CPB and post-operative atrial fibrillation were the strongestpredictor of post-operative stroke with odds ratio of 9.50 (0.75-119.7) and 5.43(1.42-20.77) respectively. The odds of having stroke after CPB in hypertensivepatients was 5.43 (1.42-20.77), 2.27 (0.23-22.53) in hyper-cholestremic,1.13(0.24-5.25) in patients with family history of IHD, and 1.06 (0.25-4.55) indiabetic patients.

Conclusion: Post-operative atrial fibrillation and requirement of high doseinotropic support after weaning from CABG are the strongest predictor ofperioperative stroke.

Key Words: Stroke, CABG, Atrial fibrillation, Inotropic support.