Elin Metta Jensen, Katrin Juniana Larusdottir, Erla Liu Ting Gunnarsdottir, Sunna Lu Xi Gunnarsdottir, Anders Jeppsson, Tomas Gudbjartsson
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引用次数: 0
Abstract
Introduction: One of the most serious complications of surgical aortic valve replacement (SAVR) is stroke that can result in increased rates of complications, morbidity and mortality postoperatively. The aim of this study was to investigate incidence, risk factors and short-term outcome in a well defined cohort of SAVR-patients.
Materials and method: A retrospective study on 740 consecutive aortic stenosis patients who underwent SAVR in Iceland 2002-2019. Patients with stroke were compared with non-stroke patients; including preoperative risk factors of cardiovascular disease, echocardiogram-results, rate of early postoperative complications other than stroke and 30 day mortality.
Results: Mean age was 71 yrs (34% females) with 57% of the patients receiving stented bioprosthesis, 31% a stentless Freestyle®-valve and 12% a mechanical valve. Mean EuroSCORE-II was 3.6, with a maximum preop-gradient of 70 mmHg and an estimated valvular area of 0.73 cm2. Thirteen (1.8%) patients were diagnosed with stroke where hemiplegia (n=9), loss of consciousness (n=3) and/or aphasia (n=4) were the most common presenting symptoms. In 70% of cases the neurological symptoms resolved or disappeared in the first weeks and months after surgery. Only one patient out of 13 died within 30-days (7.7%). Stroke-patients had significantly lower BMI than non-stroke patients, but other risk factors of cardiovascular diseases, intraoperative factors or the rate of other severe postoperative complications than stroke were similar between groups. Total length of stay was 14 days vs. 10 days median, including 2 vs. 1 days in the ICU, in the stroke and non-stroke-groups, respectively.
Conclusions: The rate of stroke after SAVR was low (1.8%) and in line with other similar studies. Although a severe complication, most patients with perioperative stroke survived 30 days postoperatively and in majority of cases neurological symptoms recovered.
期刊介绍：
Læknablaðið er fræðirit sem birtir vísinda og yfirlitsgreinar og annað efni sem byggir á rannsóknum innan læknisfræði eða skyldra greina. Læknablaðið er gefið út af Læknafélagi Íslands. Blaðið er sent til allra félagsmanna. Það var fyrst gefið út árið 1904 en hefur komið samfellt út frá árinu 1915. Blaðið kemur út 11 sinnum á ári og er prentað í 2000 eintökum. Allt efni Læknablaðsins frá árinu 2000 er aðgengilegt á heimasíðu blaðsins á laeknabladid.is og er aðgangur endurgjaldslaus og öllum opinn.
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