Mizuhara A, Ino T, Adachi H, Yamaguchi A, Murata S, Kamio H
Department of Cardiovascular Surgery, Omiya Medical Center, Jichi Medical School, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1995 Dec;43(12):1907-12.
From January, 1990 through July 1994, 615 adult patients were undergone cardiovascular operation under the cardiopulmonary bypass. Sixteen patients were suffered perioperative cerebral infarction. The etiology of the cerebral infarction was evaluated on the pre and postoperative brain CT findings by the neurologists. In the 283 coronary artery bypass operations, 4 patients suffered watershed infarction (WS) and 4 cerebral embolism. In the 252 valve operations, one WS and one embolism. In the 80 thoracic aortic operations, 5 WS and one embolism, respectively. The risk factors of WS were the elderly, emergency, the longer operative period, and the longer cardiopulmonary bypass period. The risk factor of the embolism were male, preoperative cerebral infarction, the calcified finding of the ascending aorta by the chest CT. It is important to take preventive strategies against the watershed infarction.
1990年1月至1994年7月,615例成年患者在体外循环下接受了心血管手术。16例患者发生围手术期脑梗死。神经科医生根据术前和术后脑部CT检查结果评估脑梗死的病因。在283例冠状动脉搭桥手术中,4例发生分水岭梗死(WS)和4例脑栓塞。在252例瓣膜手术中,1例WS和1例栓塞。在80例胸主动脉手术中,分别有5例WS和1例栓塞。WS的危险因素为老年人、急诊、手术时间较长和体外循环时间较长。栓塞的危险因素为男性、术前脑梗死、胸部CT显示升主动脉钙化。采取预防分水岭梗死的策略很重要。