What is the risk of neurological deterioration during cardiac surgery after a stroke?
Investigations have suggested that the risk of neurological deterioration during cardiac surgery after a stroke is lower than initially assumed, particularly in patients with silent cerebrovascular emboli. Studies have shown that hospital mortality rates as a function of the interval between evidence of cerebral infarction to cardiac surgery were 66.3% when surgery was performed within 24 hours of stroke and gradually decreased every week to 7.0% with surgery >4 weeks after stroke. Additionally, Ruttmann et al analyzed 65 patients who underwent cardiac surgery after cardioembolic stroke (median time, 4 days; range, 0 38 days) and found that surgery in this time frame was not associated with worse patient outcomes. Fifty of the 61 patients (81.9%) with CT-verified preoperative stroke survived cardiac surgery, and full neurological recovery was achieved in 70% of 50 stroke patients.